HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
DatePermit Number: "Q
K-02 WN IM
NO I-W- --W--
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:
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Address: 10410 S.00kq,J W. 'W 8O7
Property Tax ID#: 4.511 ,51y -00r.1-000-4 Lot No.
Site Plan Name:J{j[(&„mAj /SLAAub C-f-0 , Block No.
Project Name:
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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:$ a,obo.00 Utilities: —Sewer —Septic Building Height:
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Name t _MAL.i1QMA Name: C41S ROCaac
Address: 15490 IJ AgUlt gAVE, Company: CAAVAL,PLUI,%6144 50eVJW MC.,
City:-LAKWCOD State: Co Address: 971 SW LAMAHUM Me.
Zip Code: 90ola t Fax: City: &-r s*yjr Luce State:FL-
Phone No. (720) Zip Code: Fax:
E-Mail: Jv _ tM�+.fERAt,S.tor► Phone No 7'72) R40-1144
Fill in fee simple Title Holder on next page(if different E-Mail fi1/"1 n/1 81 Qri�a� .Gow•
from the Owner listed above) State or County License
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.
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not
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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."
"Milo &Amt
Signature of wn /Lessee/Contractor as Agent for Owner Signature of Cont act /Licerise.Holder
STATE OF FLORIDA STATE OF FLORID
COUNTY OFA COUNTY OF
The fgoing ins en wa a n wledgrbefore me The fgxgoing ins men wa a� cknowledgedbefore me;
thisday of ,20� by this day of � 20 by
CIS avis boa
Name of person making statement. Name of person making statement. .
Personally Known_)OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary PL of I (Signature of Notary P b of
CARVALHO
MY COMMISSION S FF960795 =`: ''3 MY COMMISSIONS FF968705
Commission No. . EXF(I )Match 22.2020 Commission No. EXPIg6@&J*ch22,2020
14071396-0'53 nbndaNW� $ervkw.can 14071798a'S3 flagallou oar
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 9