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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �� � �� ®��� Date: . 1212119 Permit Number: Fn ECEIVED ._1111 "'I'll- _-. I 1"1111111111 Jill_.; Building Permit Applicati EC 0 3 2019 Planning and Development Services ie 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: RSC cv e. oma} PROROSED IMPROVEMENT LQCATIQN ... . h TM> Address: Nkeai4r'r(1-f*WN Property Tax ID#:_ I I-SQ j—,�Q, ' (�Q� ' ! Lot No. Site Plan Name: Block No. Project Name: DETAiLE© DESCRIPTION aF WORK Corr VXAtd► At aiiaZnoA dv,C-k %C t.M kkec.+ciCG1 , CONSTRU,C INFORMATION`: �� s r-: A 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:$ 'S2 Utilities: —Sewer —Septic Building Height: U>WNERJLESSEE y' 1,001NITFACTt)`RZf Name �' Name. - 4,t1G Ck V Address: Z Ir Company: $;L- 15 nn %M es- 1.�. City: 9C'L- State:fj- Address: &JOS T��C.�p�1, AV3C. Zip Code: S!JCtS_ Fax: City: !Gar k PXc9c - State: Phone No. Zip Code: :34civ Fax: E-Mail: Phone No 2 Fill in fee simple Title Holder on next page(if different E-Mail L CIXOM from the Owner listed above) State or County License�� 7_ 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. SUpPLEiUIEN AL CONSTFtUCTI�N LIEN LAUII IN �RMAT O I �M9"' x77 F r� .. e,„ - ✓ w w 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 thepermit 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 Asstcigtion 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 LE DER OR•AN ATTORNEY BEFORE RECORDING QJR NOTICE Of COMMENCEMENT." Signat a of n r/Le ee/ ontractor as Agent for Owner Signature of Con ractor/Licens der STATE OF FLORIDA STATE OF FLORIQA, COUNTY OF tyk-,Lute, COUNTY OF The forgoing instrument was acknowledged before me The for oWg instrument was acknowledged before me thisp�day of Ogd4wbW 20A by this day of �p(p_p AA6eT ,20 by Name of person making statement. Name of person making statement. Personally Known�R Produced Identification Personally Known OR Produced Identification Type of Identification -Type of Identification Produced I Produced T 4 (Signature o otar Public-St Y&Qorida) NOEGOMEZ (S gnature of Notary Public-Sta o , is a ALICRABLANCO 609, os 8'Q0 _ • ' c*MY COMMISSION#GG 056806 £+iP WON# Commission No. 0, ® '`0 ��S:Decembet20,2020 Commission No. � L'b ,.,� �'�eIRES:OcfAber20, 4FF"13 Bonded llm Budget Notary Services �(y(� q s••.,,, ;,,fir Bonded 7fim Notary pd* REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.2 7 19