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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: � Permit Number: "ED arw pit. ri,� R SO or —- Building Permit Appl'cation NOV -5 2019 Planning and Development Services Building and Code Regulation Division Permitting Department 2300 Virginia Avenue, Fort Pierce FL 34982 f L C e CoU n t Phone: (772)462-1553 Fax: (772)462-1578 Commercial Yr FL PERMITTYPE: PROPOSED 1M, ROUEM,ENT LOCATION: Address: t 660004* /o11zT- P, �N�e Property Tax ID#: Z ZZA 3 ^ 5 03 -6'000 ' ©O O 0 Lot No. Site Plan Name: Block No. Project Name: �S/ypdS GJot/� DSSf�G�s9-�c . ) ©ETA SLED D1,1-IRSIPIT,IONOF WORK: SGyrk4 oJO V CON5TRUCTI©N INFORMATION: Additional work to be performed under this permit-check all that apply: Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors *Z _Electric _.Plumbing _Sprinklers _Generator _.Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ o Utilities: —Sewer Septic Building Height: OWNER/L�Ex-SSEE: CONTRACTOR: Name V I Si��wC Cbc�(�1 Name: ,�C�1� � Address: !/6900 Qr t4wk4 �-)/'� Company: C4,,, /„Q40 E'1PC- City: -�- /Jec�c,�,. .. - State: Address: (v7o S2 l�2oov`�'e�,, 2rp Zip Code: Fax: City: _Sc ca►uv�`t= State. 0 Phone No. 7�� (�l�'�?Es��? Zip Code: f,Zip Fax: E-Mail: Phone No 77a-�23>^.235 Fill in fee simple Title Holder on next page(if different E-Mail �r-ti�v e-go (ocA 1 94,p-- from ,oc,from the Owner listed above) State or County Licensed 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 SUPPLEMENTAL CONSI"ft+044T1,ftOFIEN 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 LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Signa of Owner/ ee/Contractor as Agent for Owner Signa>Pce5f Contractor/Lic e Holder STATE OF FLORIDA STATE OF FLORID COUNTY OF. COUNTY OF Z, L The forpmg instrument was acknowledged before me The f ing instrument was acknowledged before me this f Day or A 20A by this rday ofPI R V 20J�by Name of person tnaking statement. Name of person haking statement. Personally Known OR Produced Identification ✓ Personally Known OR Produced Identification / Type of Identif ci a to Type of Identific Produced Produced r/ rl 07�C(iJ ( gnature of N Public-S a F (Si a ure of NotaW Public-.State of Florida) ., AUDREY B.HUMPHREY ��JON Commission o?' a. :°= Commission N ,tAdvv .HUMMISSION1 60817 u�r •EXPIRES:March 6,2023 � f.; #GG 300817 v'. axaverrs - .•a+xsnro+es-vscrsnsm '•'aet �,FOF�L�PP. and d March,' Und fl REVIEWS FRONT ZONING SUPERVISOR PLANS V' ItO, ROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW " REVIEW DATE RECEIVED DATE COMPLETED Rev. 2/7/19