HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE I JFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _G
Date: k Permit Number: �
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Building Permit Applicati®n S
SEER 1112. 19
Planning and Development Services
-ST.,Lucie,County,;..Fermj't4
Building and Code Regulation Division ____�____�_ _-• —
2300 Virginia Avenue,Fort Pierce FL 34982 /
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential v
PERMIT TYPE t� /I MCI
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Address:
Property Tax ID#: 1 1DLopt) Lot No. ! l 1
Site Plan Name: Block No.
Project Name:
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Additi al 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:$ L./ Utilities: —Sewer _Septic Building Height:
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OWNER LI= SEE3� x. bK
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Name Name:
Ad s: Company:
Cit State: Address:
Zip Code: Fax: -EL-
City: State
Phone No. Zip Code: Fax-
E-MaJV VT1r Fill in in fee simple Title Holder on next}gage if different E-Mail�-� l
from the Owner listed above) State off 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.
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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 buildingpermit 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."
S' n re of Own e ess /Contractor as Agent for Owner Sign ur f Contractor/License Holder
STATE OF FLORI �� 1� STATE OF FLORIDA, r �o
COUNTY OF L COUNTY OF C
The for Iq ing instrument was acknowledged before me The forg .i*g instrument was acknowledged before me
this day of �DkE�Q1P/� .20 10J by this�Tda_y of $D PSP 1V(,C!' ,20_n by
J Oct-A � I` -z cool n )Q&A �--Vy cuoto
Name of person making stement. Name of person makin:ZOR
nt.
Personally Known V OR Produced Identification Personally Known roduced Identification
Type of Identification Type of Identification
, Produced Produced
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
e1, Shead Dominick �/� $�,
Commission No. tl 1, (Seal) StateofFlorida Commission No. gq e,� (SeapneadDomintok
ac My Commission Expires 08/18/2 1 = ° State of Florida
*runissi * M Commission Expires 06/18/202
of rk Q` Comi iission No.GG 115596—
REVIEWS
155 6REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SE*A TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.217119