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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLENyF0 UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED G Date: / /q Permit Number: .R RECEIVE[ ♦ R I R Building Permit Applicatio SEP 17 ?Oi9 Planning and Development Services ST. Lucie Count P Building and Code Regulation Division Y, ermitting 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT rTYPE:63s; PROPOSED IMPROVEMENT LOCATION: Address: .50 (O S, AI TA 64 A 9A Property Tax ID#: l3 0C90 2-5 (9c:;)0 Lot No. j Site Plan Name: /.AlirC-Luaop (7t421C yl/J �,/ Block No. Project Name: _5i4.vT,4 D TAIILED DE CRIPTION OF 1NOR+K: (,ter* .190/,/ c1..-5-S � it/ Sf��/� UAJdel-la v, `'A1-IJ -red 14cr' ZVIY, 41666 >lec-f CONSTRUCTI'Q IN!FORIVIATIO 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: / 4 7Sq. Ft. of First Floor: Cost of Construction:$ /�, 0�D Utilities: —Sewer _Septic Building Height: OWNER/LESS wE: CONTRACT-OAR: Name YAS Ho I Ji yv ' LG Name:;__9 e) Lei C1 -W (' .., ., .�...;; Address: .gI ',O :p�r�inl Su1��:..,��'� ��'o �/n! Company: k � e. � S•�4 City: 130�a "' r State:�-L Address: j 3 b �. ' . I dA d,AN Zip Code 3 Fax: City: hoe 1 4-t Q, State: Phone No:' j( � � yZip Code: �I S �• Fax'- n E-Mail: Phone No 7 Z;- d a Fill in fee simple Title Holder on next page (if different E-Mail A edd' -- epnr s`hL' "'-J 3 1 C from the Owner listed above) State or County License ' ic CC 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. SUPP EMEN AL CO TRUCT O L E W I' 'O AT©NDO 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 gra nting'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 MUR NOTICE OF COMMENCEMENT." i Si ure of Owner/ essee/Contractor as Agent for Owner Sig ture of Contractor ' ense Holder STATE OF FLORID jq r COUNTY OF STATE OF O� COUNTY OF � li The forgoing instrume t was acknowledged before me The fqr oing instru t was cknowledgt before me this_/_7 day of J 20�G y this day of 20. by Name of person making statement. Name of person making stateme . Personally Known V OR Produced Identification Personally Known O R Produced Identification Type of Identification Type of Identification Produced Pro �T,�? (Signatu- f., 9,ubl' - d1L� �r� la (Signature ary,. ,u Ic- taly8� I€ dl4 dnt �• otaryPublic—State of Florida ��vP�o., •'` CommissionNGG139�a1 Commission •P` Notary Public-State of Florida Commissio ) g 1'-• •`-- Commission#GGC {) „ OF Fl.,,.°r empires Dec 20,2021 °? or: y omm.Expires Dec 20,20 1 Bonded through National Notary Assn. ?`F Banded through NationalNotaryAssn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 2/7/19