HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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0 RECEIVED
RECEIVED
Building Permit Applicat RECEIVED
13
Planning and Development Services
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Building and Code Regulation Division 'ST, L"cl, County, Permitting
Pe]
e C rmitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMITTYPE: A1c_ .. C,)rx90SJ _0uA L%kL (Fir CAO
PROPOSED IMPROVEMENT LOwidk
Address:
Property Tax ID#: ( ta;!�) - mo - _C; Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
ttt XaL +(Yt,.N sAs-I&M V-407C CA IrL
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CONSTRUCTION,,:INFORMATIIO'N' :
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:$ Utilities: —Sewer —Septic Building Height:
-OWNER/LESSEE:
CONTRACTOR:
Name T)CLV�6 Name: C)&_
Address: rIPCI-V 0 rS RbUJ Company: 0(NQSAQ(?_ _A[C_-Z M-0A 9666.
City: State:_2- Address: adPQQRL
Zip Code: Li_S Fax: City:- A- State:_Lc
Phone No. Zip Code: QtCkg-� Fax: Lo,a if�J
E-Mail: Phone No rn a- LA L9-k-slat
Fill in fee simple Title Holder on next page if different E-Mail iQ�Zect a 2 a) @_ �o CCAY-%-
from the Owner listed above) State or County License 01rAcIva I U-S 92-
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.
SUPPLEMENTAL CONSTRUCTION LIEN"LAW INFORMATION:
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 NTEND TO OBTAIN FINANCING, CONSULT
W OUR LENDS R AN ATTORNEY BEFORE RECORDING YOUR ICE OF COM NCEMENT."
Signa a of Owner/Lessee/Contractor as Agent for Owner Signature' fContractor/License Holder
ST E OF FLORIDA STAT OF FLORIDA
COUNTY OF a�. Oc "� COU TY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this \'IS day of'Sk 20N'% by this k1z day of 'Sjt.A-%v 201!i_ by -
S-vyo%uS�R
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced 'Fu t_, Produced
{Signature of Notary ublic-5 oNgGG OV0 {Signature of Nota&Public-State of Florida
. ......,,.„” GOMM�S� 18.2020
Commission No. O - Fx )D Q �atlnaecen ^Commission No.q-<r'o'4'�. °�~ � '% D NAMARIEGIYE>�}S
iic5 'ri day tyat8lY ."-. MISSION#GG 02202
'!1rE..•OP• S0"� ;o�.r= EXPIRES:December 16',2@24
-+ ota Pubric Unde
REVIEWS FRON ZONING SUPERVISOR PLANS VEGETATION RTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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