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HomeMy WebLinkAboutBuilding Permit Application ' � I I I All APPLICABLE I FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED f�j Date: l Permit Number: L ` 00 C0 U NT Y EC VE ' LP7ermitting Building Permit Applic Planning and Development Services tment Building and Code RegulationDivision ' F2300 Virginia Avenue,Fort Pierce FL 34982r L Phone: (772)462-1553 Fax: (772)462-1578 Commercial ►►►/// Residential PERMITTYPE: OFOS ► I RO L• ©N. Address: CSR- , EGES '_R>k 6C'c� f-I 3-619 SI Property Tax ID#: 133S F-02 ' 06r)?s_ pGQ_Q Lot No. 23 . Site Plan Name: (0K) 6t(Z Block No. 7� Project Name: d C Ac- L)W 75 D A CSD DE�SCftlPT O © WORK: &!I— u PAIS a t6ss-r Tv:Ju C_ cA-.)T DF ' AeQ9 CONST UCTION INFO�R A ION• Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank —Gas Piping _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ b� 2 Utilities: _Sewer _Septic Building Height: STMINSIETRINE�SSEE: C• TRA QR: Name &F ,g zone .cam S��zvrc�S. i cDC Name`�sC�SP—Z ��N Address:.. (O 7�"fa-C kVG-N Company: LSC, City: 5§ q l.. f.,�l(tS' State: L;J_ Address: 4 dS ...0t- Zip Code:Q L O`�. -,.Fox: City:��(L� 57 C�c rl State:_ Phone No. �y C,S Zip Code: Fax:'- E-Mail: Phone No SSI r S ^030-6 Fill in fee simple Title Holder on next page(if different E-Mail VJ 0,we- LQJ'') from the Owner listed above) State or County License d.Scq If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required. S FIRtf 15 M7,156 TAL CO OSER,OffiffiNNA1001MT,ATIO'N: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit, I do hereby agree that I will,in all respects,perform the work in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Signature of Owner/ For Owner Signature of Contractor/Lice+e Phlde --• - STATE OF FLORIDASTATE OF FLORIDA COUNTY OF COUNTY OF The fgrgoing instr knent was acknowledged before me The foing instr�ent was acknowledgepefore me this U day o26/1rgo 20by this (O day of of , 20 by R D Oe r-'T ,S'-) y N-E d'o,6 E-dc" TO Nt - Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personal) , nown OR Produced Identification Type of Identi ' tion Type of Iden ' i ion Produced C' _A_C_ Produced - (Signature of(Votary Public-State of Floridan (Signature of N ary Public-State of Flor' . `t,,RY PU•• AUDREY B.HU PH EY r; `t;�vv��• AUDREY B.HU PHREY Commission .o. Commission N• �; M Y GUIOIMISSION �� 00817 ': MISSION 7 *. • i*e t EXPIRES:March 6,2023 ' :`.� _ EXPIRES:March 6,2023 ' Bonded TrU NOWY PuDac_uni Lrwf_ r ion a ru �' r„s REVIEWS ZONING ^SU-PERVISOR PLANS VE'G'EfiATiC7 SEA TU RTI F MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.