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HomeMy WebLinkAboutBuilding Permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / Date: Permit Num — (J / © v KELISMI Um A 96 V Lip - Imm AW"9693 AM Man cmft� SEP 9 I� Building Permit Appl c�eron 2019 Planning and Development Services mltting Department Building and Code Regulation Division St. Lucie County, FL 2300 Virginia Avenue,Fort Pierce.FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMITTYPE: WO er PROPOSED INf�R®Vl MENT' OCA�T �� .� � Address:�0J Q PM Aga .0 A, FT. .0/ A.Ljf J"I _ 3 y FF Z Property Tax ID#: O� tLot No. Project Name: 1 N C J�DZESC,,P�RJPTIG��� 116 RZAL4r-of 4v 44 L dfi/7-7-6,t J{�T6lL CONSTRUCTION IN`FORMA1'I®N: Utilities: _Sewer _Septic Sq. Ft. of First Floor: Cost of Construction: $ Total Sq. Ft of Construction: #=L.®QDPLAIN 0 RAR OW",ENI' 'ERT oast ructu s a erupt fr rn Builcli Code t at are in the floodplain• 3 Nobrfesidenzial Farm Bui ding: emp Idg/Sheri used exclusively far constr ction obi'le/ odular ar tem .constructic►n�office: Bldg. in •hied.in disfirib.of elecfirl�ity: Other: . Flood Zone: B'FE: Floodway?1�/N if Yf` o Rise C�erki I:cate ith upporting data att shed? /N - A I other appl�le�abfe state and.federal permits sha'I be obta';.ned prior to co= menceme t of construction. i QV1IN'RR Name dAVlD 'aAtIV's ur•J Name: Address;_ **n Bda P/Z Company: City: 11-T P 1E/L e-4 State:/-� Address: Zip Code:.4 S'y y Fax: City: State: Phone No. 7 7-7 y,ld_ �/3 S Zip Code: Fax: E-Mail: Phone No Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License 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. 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 end 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 Commencementmust be.recorded and posted on the jobsite before the first inspection. If you intend to obtain financing,consult with lender or an attorney before commencing work or recording our Notice of Commencement. Signature of Owner/Les ee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORI ,���g ;.;., STATE OF FLORIDA COUNTY OF COUNTY OF The f going instrunt was acknowledge before * ' The forgoing instrument was acknowledged before me this / m day of by this day of .20_ by ix 'noc 01 h s 5 51 Name of person making statement. y Name of person making statement. moo . Personally Known 1� OR Produced Identifica jp"n ? Personally Known OR Produced Identification Type of Identification u Type of Identification Produced Produced i. 5 (Signature of Ncory Public-State of Florida) (Signature of Notary Public-State of Florida) Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.