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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: \a� Permit Number: RECEIVED Building Permit Applicati n OCT 1 A ?J�9 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: PROPOSED 6M'RRO1/EMENTLOCATIDN: Address: 2 Z Ks- IV,PropertyTaxID#: �y3�"'�� a._aoA3Lot No. Site Plan Name: Block No. Project Name: ©ETAiLED DE=SSC«RtPTI(ON Of WORK: 2 UJA-J kl G�. CONSTRUCTION INFORMATION: Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Vectric —Plumbing, _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ ditfilities: _Sewer _Septic Building Height: OV1/NER LE=�S�SEE; C©NTRACTOR: Name w (l i "G'�ilr,✓'►/ Name: C j /; 'L5/7-1/ Address: OE Company:. City: ('L��/C'_'-:c` State: Z Zip Code: Fax. City: ' L ` State:-'r� Phone No. S l->2•" 0 Z/' Zip Code: ' Fax: E-Mail: Phone No Fill in fee simple Title Holder on next page (if different E-Mail K_0 194 G from the Owner listed above) State or County License �7 (I 2 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. PF EMEN7AL CONS Rll IDN EN LA N =T DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _N'ot 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. 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, perforin 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." Signa er/Lessee/Contractor as Agent for Owner Signatur ractor, se Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 5k '-0 c-%'4- COUNTY OF --*N-.L����f The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me thisNO day of 411-* . 20 A by this la day of dc-t ,20,�, by i.�a .a;�,: , CaV�,tI%-,�.v � W\�-\k i�d�.WAr, ,J 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 '� l ' wm mARIE GIVENS (Signature of Notary blic-State,.� IE GIVE Si nature of *. r� ic- 4i� 6 D NA #GG 022023 ( g lry mbar{6,2020 •,'i'+na4,,� I p61MlSS x16 2020 SN ;a<_ EXPIRES:�ece Unde�ers Commission No. :Deep iaUnders0l, ommission N N ry� gond mr,Notal •rFo�Ft. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.