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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q(! )q rDate: / /gam Permit Number: - © LA0 I RECEIVED ` SEP 2 0 2019 Building Permit Application Planning and Development Services ST. Lucie County, Permitting Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: �p 1\QO® U 0© P' OPOSED 1MPROUEM ANT LOCATION: Address: Z-5-3 011-14- Property 11-Property Tax ID#: I ��' �v �' © � 3�• o� Lot No. Site Plan Name: Block No. Project Name: DETAIEED ©ESS"� IPTIO OF WORK: C•ONSTRUCTIO INFOR ATiON: Additional work to be performed under this permit—check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters Zwindows/Doors Electric Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ 15-0 000 Utilities: —Sewer _Septic Building Height: OWNER/LEISSE : CONTRACTOR: Name - Name: v Address: ,L/ - Company: City: - (/�-z - State:G_�. Address: ZSA 3 State:ZiP Code: Fax: Phone No. �7� �1��a/'� Zip Code: Fax: E-Mail: Phone No �,19- V O Fill in fee simple Title Holder on next page (if different E-Mail n- .� from the Owner listed above) State or County Licen e C2!5G/Q- d-d® 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. N?MNEME @MMWMM Mi LAW dvmm7moo: 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 thepermit 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 INTf TO OBTAIN.FINANCING, CONSULT WITH YOUR R AN ATTORNEY BEFORE RECORDING YOUR ICE OMMENCEMENT." e4a� Signatur of ner/Lessee/Contractor as Agent for Owner Signa o ractor/License Holder STATE FLORIDA STATE F FLORI�A L COU , OF sV.. 1:�1 c;.e COU OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this, day of Se �T 203A by this \"qday of S� � 20� by Name of person making statement. Name of person mak)ng statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced D L Produced �l4 �00�, (Signature of Notaryublic-State of Florida) nature of Nq ic-Stat@ j6V1#c'c' 0 g ON— . M'f Ca p,cetnbet lBn IS Commission No. g�C1N-a'-w5 SIE��pZ2 o ission No. O�M1Sg10N�16,Z ' rgv ';*"s ?1 11oWtY REVIEWS FRONTp Bo d�l� R PLANS VEGETATION SEA TURTLE MANGROVE COUNTER f�' EVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 2/7/19