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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 1�,�, �� Permit Number: _, RECEIVED - Building Permit Applicati n OCT a 8 2099 Planning and Development Services sT. Lucie County, Permittin Building and Code Regulation Division g 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: PROPOSE© IMPROVEMENT LOCATI©N: Address: £r CJ+ Property Tax ID#: / /= �o S� o� �� Lot No. Site Plan Name: Block No. Project Name: Lai QEIAILED DESCRIPTION 0 WORK: QL C+ NSTRUCTION UN1=0RMATION: 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:$ ;2,SC�O . Utilities: —Sewer . —Septic Building Height: OWNS�R/LESS�E: CC�7NTRACTOR: Name t ! AZp�-nn c L.( Name: ' r I � -Addre s:.:,,.•:a ,:. :. c�-42_ Company:_ �_Pca:�.b.✓ :a�+k+� �Ol — .City: _ �'.c,� State: :.Address°"' .3�'�y �- iJ S I UrU,'� i 4 Sw Z; - city: Code: �_a1 �.'.f4a, I Fax:' -79 a ' i�`�-r`77r��' City _ �` State: Phone No.=�-7a,Cf -�� y�f Zip Code: -.3yM,4- Fax: E-Mail: 19 L 4.®;7, Pb0e,No <.'�;, ' �(6k- /�3 /J Fill in fee simple Title Holder on next page(if tliifferent -E-Mail X+,P4e.►-PAS '0— 7AL• CA,01 1 from the Owner listed above) State or County License C=G a0(v 2 S'90 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. SUP LBME L Re O N STR+UCTIO LIE LAW F'C+)RMANO tJ 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 INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." . C nature of 0 er%6ee/Contractor as Agent for Owner Signa r e of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrume was acknowledged before me his td�y of 204 by this Zj� day of r 20a by Name of person making Atat Name of person making statement. Personally Known OR Produced Identification Personally Known !/ OR Produced Identification Type of Identification Type of Identification Produced Produced � 4�_, Z<_,__ (Signature of Notary Public-State of to ida) (Signature f Notary Public-State •1vi+� ILONA A.NARDIN / ': Commission No. �� ��l� (S IZ••" ���P' ��. �I�Notary Public-Stateof or o�"R ILO . Commision a GG 078)9' It s _. 7.NA!7N O« n. of Florida +� �P`,• MY Comm.Expires May 2,2 1 •�`�oFFl.o��: MY Comm ExoiesM2021, y REVIEWS FRONT ZONING �I�ro ghA Assn GETATION SEA TURTLE MANGROVE COUNTER REVIEW RE E EVIEW REVIEW REVIEW DATE RECEIVED DATE. COMPLETED ev.