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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 Date: /O/SR II Permit NumbenA9021 11M IV RE st 0,t: tD OCT 8 2019 Building Permit Appl cation Department Planning and Development Services Permitting p Building and Code Regulation Division St. Lucie County, FL 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772) 462-1578 Commercial Residential PERMITTYPE: WINAMPOWN Address: /3f)- AC A&rc n�a-- A v Property Tax ID#: / 1` lJ © lam D-7 Lot No. Site Plan Name: Block No. Project Name: • O WO ,�7�[, XSi-1iNGr4arQG2joC�C WiAV% Same_ 5iu «XJ 'J � ' C O fON• 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: $ t?60 U-Q Utilities: —Sewer —Septic : Building Height: �S ESE: «ONITATO Name ��eNe- gae-llw Name: 7's��� 13dr2a Address: 13'1- NE -Nar&W IA Ave- Company: Ar l ac.h (neat: an_ hoc,en 1 City: SSI_ State: FL Address: LIQ(w nu r.� Iter J �a AIdd Zip Code: 3kg4S3 Fax: City: PSL',' Stater Phone No. 5G i- 701-132 Zip Code: 3114$3 Fax:. E-Mail: Phone No 7?Z-zzf"5'ql l Fill in fee simple Title Holder on next page( if different E-Mail - aat-810rIA 6m , Calan from the Owner listed above) State or County License 28365 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. SUPPLEMENTA C«tONSTRUCTI�DN LIEN LAW {NFURMATiO{ • 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 AFFIDAVIT: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. LucieCounty 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 LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OVCOMMENCEMENT." Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA - STATE OF FLORID COUNTY OF COUNTY OF The forgoing instrum nt was acknowledg-1 before me The forgoing instrpknent was acknowledged before me this day of 20�L// by this_YL day of 20)1' by Name of person making statement. Name of person making statement. Personally Known e_� OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of N ry Public-State of Flonda ) (Signature of N ary Public-State of Flo ida Commissiori No. ;sYPU;'•, AUDREYB($Mbl�HREY �! Commission No. ;'�! ;," A.UDREYB.HU N EY 2' MY COMMISSION GG 300817 MMISSION0817 ="�• S March 6 2023 EXPIRES:March 6,2023 .•rF. .ac: ° ,� n •I -AAs oc FL Bo ded Thru Notary Public Undeavri,i�rs 13 % REVIEWS qffffF �E 71SOR PLANS VEGSEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Te—v—. 2/7/19