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HomeMy WebLinkAboutBuilding Permit Application i I - i i i All APPLICAB FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: I ♦ IP , Building Permit Application (Planning and Development Services Building and Code Regulation Division 12300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial X Residential ,IPERMITTYPE: PROPOSED IMPR01/EMENT LOCATION: Address: Property Tax ID#: SZZ�O Lot No. Site Plan Name: Block No. roject Name: G VLV_� P 1 Qe� DETAILED DE�SC«RtbPT[ON OF WORK: &A(I QQP� 4 VICA /Discokheel V,ZbD,A 0(__40 SPCAC�l VCMN&� if Ais CONSTRllCTION INFORMATION: lAdditional 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:$ ��f Utilities: —Sewer —Septic Building Height: OWNER L E: CONTRACTOR: Name Name: G&w iAddress:-1 6Ss ( ritA pblptO Company: �e C City: State:JC Address: � ti Zip Code: Fax: City: State:261 Phone No. Zip Code:3_//1M Fax: E-Mail: Phone No Fill in fee simple Title Holder on next page(if different E-Mail G(I-M d>. from the Owner listed'above) State or County License (� w y,7b 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 111106 NW CC�7NSTRUCTIM [ER LAW I, FaRMATI©N: 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 ITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR L D R AN ATTORNEY BEFORE RECORDING YOUR NOTICE Qf COMMENCEMENT." Signature of Ow r Lessee/Contractor as Agent for Owner Signa re of ontractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 1 day ofF�l 2619 by this I day of { J ,20]� by Name of person making state ent. Name of person making stateme t. Personally Known OR Produced Identification �' Personally Known OR Produced Identification Type of Identification Type of Identification Produced1 L_ Produced -_ gn ture of Notary Pub' -State of Florida (Sign ure of Notary Public- ate of Florida), Commission No..' (Seal) Commission No. (Seal) IN - I,c *_ y .OMMISSION;�3G275060 { REVIEWS € ) cemb r ��RVI OR PL E, MANGROVE 6oid � r��1 ryPublcUn 6t?cti REVc�E iNAINGZA;ti .r.EW; REVIEW DATE N. ivb RECEIVED =7s�aF�LOQ EXPIRES:Dec mbar20,202;_' 13ondedTt DATE COMPLETED ev. 2/7/19