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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE IN7 MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED d� Date: Permit Number: ` Y(%k-`3 Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 iPERMIT TYPE: RECEIVE® Building Permit Applic tion SEP 2 7 2019 S7". Lucie County, Permitting Commercial Residential ddress: :�. �flS /,lf��?i �' G/X-(A roperty Tax ID #: % 3 01- 6/S �� _ — O Lot No.� ite Plan Name: Block No. % roject Name: i?ET ILED DE�SGR+I�PTION OF WORK: ,< V > ,r/4L rXe //1%4P/C,0/!r, Additional work to be performed under this permit — check all that apply: _Mechanical _ Gas Tank _Gas Piping _ Shutters _ Windows/Doors _ Electric _ Plumbing _ Sprinklers _ Generator ZRO& S >02 `Pitch Total Sq. Ft of Construction: .78 Sq. Ft. of First Floor: Cost of Construction: $ ,/ v? Utilities: —Sewer —Septic Building Height: OWNER/LESSE'E: CONTRACTOR: Name' Name:�C>/�- �J /2actb-�i Address:'- IWO 516,C ipang:. City: ' ' �.4J.�� Lu2_' ` State: XL Zip Code: �j ✓�� Fax: i Phone No. ..Address: oqy- 4z S ;City: ' L12�% /� State: t� " Zip Code: Fax: Phone No X�a S 3a E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail C i'i red r A Lbdd/) State or County License x If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. I S PMEMENTAMCONSTR}UCTIDN LIEN LAW INP©RMATfON: DESIGNER/ENGINEER: ' Not Applicable Name: MORTGAGE COMPANY: Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: Not Applicable Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is.hereby made to obtain a permit to do the work and installation as indicated. I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. The following building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTA,{J11 FINANCING, CONSULT WITH YOUR LENDER OWAN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMM EMENT." Signafure of Own essee/Contractor as Agent for Owner Signature of Contra or/ 'tense Holder STATE OF FL04VA STATE OF F A COUNTY OF k . Ly c�$ COUNTY OF The forgoing instrument was acknowledgfl before me The forgoing instrument was acknowledge before me thisl'� day of Sep 20_ by this!;1.'1 day of 20Nn by 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 Produced N' �—� �-- .� DEANNA MARIE GIVENS (Signature of Notary Public- tate ofl �atur of Not GI ;,•;D Commission No. a-� MYCOMM j$$M►0 L,�aI GG 022023 •�•.",4„ded Thru Notary Public Underwriters ����i*' 0 EXPIRES:Decem 'O` eAel�ssi No. I Pu o? Bonded is Urnlenrrriters REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW, REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.