HomeMy WebLinkAboutBuilding Permit Application 1
IAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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i Date: Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT,TYPE:
OPQSE► tMP C+3 2.1 MTJ1- A IC•} '
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Address: SLt.O oa of +F �r. ��- • l"� �� �� 3LP4g2-
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Property Tax ID#: 540. - 1,C7Lo QQ0 ! ., Lot No.
'Site Plan Name: Block No.
Project Name:
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C'� -TR CT INFORhl1 It7
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Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas'Tank _Gas Piping _Shutters' ='^ "Winnows/Doors '`
_Electric _Plumbing _Sprinklers _Generator Roof '' .Pitch'
Total Sq. Ft of Construction: Sq..Ft. of First Floor:
Cost of Construction:$ ( c2n. �� Utilities:' _Sewer _Septic Building Height:
Name % lV\C Name:
Address: 5 1..t O (�a L �?� Company a i
(( 11�s � t�
City: t- f cGr-C Q.. Stater Address.' .?i c,� ; Cs;2 q�rat� ; , . ;' :N
Zi Code: 't Fax: Cit ,I, ,.-<<s, ,n =,:,;,, ,,., ±lState;
Phone No. '17 2 Z 0 i-,O4 41. Zip Code: " Fax:' -
j E-Mail: W t vLCG - [ ' , caW& Phone No
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Fill in fee simple Title Holder on nex page(if different ail
from the Owner listed above)', ;: e
or County License
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If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,I,a RECORDED Notice of Commencement is required.
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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 contlict with any applicable Home Owners Association,rules,bylaws or and covenants that may restrict,or,prohibitsueh .
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
WITIi YOUR LENDEROR AN WTORNEY BEFORE:RECORDING YOUR-NOTICE OF COMMENCEMENT.".
Si nature of Owner/Le ee/Contractor as Agent for Owner Signature of Contractor/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 day of 'NbV(,rA „ 1 20_4 by this day of 20_ by
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'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
(Signature of N tate @ IERRE (Signature of Notary Public-Stateeof Florida) -
.., _my,COMMISSION#GG 818657
Commission No. : , IRESil�,2023 Commission No. (Seal)
•1; °c' BondedTwuwonpubticUndawtitets
REVIEWS FRONT ZONING SUPERVISOR PLANS: VEGETATION`.. SEA.TURTLE- MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW- _ REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
iev. 2/7/19