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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �' J �? RECEIV ber 9/ T>- 0 (9!�_L 0"VE' OCT 04 2019 RECEJ. COUNTY � F LORI r Bui `' uci u r � isLRE Planning and Development Services 11g DePartnlent Building and Code Regulation Division C I eC U n ty FL 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMITTYPE: ) W i n Gd- OS D P• O O Address: 2 20 e-. L% 1 Property Tax ID#: 3 01 - 0016 " UGC-- Lot No. Site Plan Name: I Block No. Project Name: &G�wi�/-l)�n - � D T 1 E � D SGR�1'PTI• • ©R . 2 (11(A do 10or-r L-1 i1-'1ti„pto�„� do 10 / 0 f tp i r'k VLAZ t,� ,"4 .t-T (.t-- Q CO UCT ON N QR A O Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank- _Gas`Piping _Shutters _/Window' s/Doors _Electric _Plu'm6ing =Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ ��.- Utilities: _Sewer _Septic Building Height: 00 ER/LESS MIRN CTU Name �Gc�-SP1'• Name: 0 L'�` Address: .2.Z'5�' �7 ve, - '_ _ Company: City: �1e1'Ce '.State:�L Address: Z go3114'.4- ­Fax: 14 !- Zip Code: 3 ,Fax: ` City: � i�'�'�e Stater t ,, .�, Phone No. 7'7 ;3• ZD Zip Code: (' Fax:71-*2- - z Ift E-Mail: Phone No 9— — G Fill in fee simple7itle Holder on next page(if different . E-Mail �����' 7 aWet P A1,9Z. ' from the Owner listed above) State or 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. SUPPLEMENTAL C«ONSTR CTfON LIE 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 INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDE R ORNEY B ORE RECORDING YOUR NOTICE OF COMMENCEMENT." Sig ure of Owner/Lessee/Contractor a gent for Owner Signature of Contractor/License Hol er S ATE OF FLO- L, DA r id-Q STATE OF COUNTY OF FLORIDA COUNTY OF ��-- The forgoing instrumerip was acknowledg before me The f?rkoing instr nt vJas acknowledge before me s r day of OC, 20 by this day of 20by Q 9 e of person making statement. Name f person making statement. / r nally Known I_ OR Produced Identification Personally Known OR Produced Identification o p of Identification Type of Identifica ' 3 o ced Produced Cr N =A � N N 00 AAw �. � c Wi atu of Notary Public-State of Florida) (Signature of State of FLD - Cn �. W 3� (Seal) oaYP��,; KAREN id NILS N o fission No. � 3pa Commission � State of Florida-No��,a�ublic =* Commission # GG 207484 My Commission Expires i June 12, 202 REVIEWS FRONT ZONING SUPERVISOR PLANS ' L GROVE i COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED. DATE COMPLETED iev. 2/7/19