HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE CQMPLETED FOR APPLICATION TO BE ACCEPTED jq1j.
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'Date: Permit Number:
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: -70� `� 598STY /W )?AD
Property Tax ID#: 1 ,�3,f'�,� - (Q13 -030K-05D O Lot No.
Site Plan Name: 1 %DD o Y'p ,�-a . L m-r Block No. 156)
Project Name:
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters /llindows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ Roof
Total Sq. Ft of Construction:
Cost of Construction: $ 11 5D
Sq. Ft. of First Floor:
Utilities: —Sewer —Septic Building Height:
Name V uvC-NT /►1► il11R-(
Address: 7(919q PQAD
City: 2� Ple&C Stater
Zip Code: 3ggS) Fax:
Phone No. GA - 38Y - YU-01-
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Pitch
Name: D01MAI flit e-
Company: WVAS s,/D mw_r (9p , 0•
Address:�K 3'%
City: I`--✓ State:
ZipCode: 3'-/ 2Y6' Fax: `1751 tea" VW 33
Phone No 7 ?)- AqO % g499
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State or County License Gp-C f 3 3 LITTO
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.
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
1"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 COMMENCE ENT."
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Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDAA L
STATE OF FLORIDA
�Gt,GcA�
COUNTY OF
COUNTY OF ,GJZ"
The forgoing instrument was acknowledged before me
The forgoing inst ment was acknowledged before me
this oQ day of!2D �4a r►�.�i a..�, 20_L& by
this day of 20JSby
Name of person ma in,mgypNpE
Name of person m 'e'ment.
Commisslon # GG 198661
Personally Kno; Eification
Personally Known ..dR.ia OR Prpdafig¢.yloentifi,�,�
."Y"
Type of Identificatio '��,,,,? 8ond� rwTmyFanlneurM80038570t9
Type of Identificati
Produced pipsProduced
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(Signatur .of Notaffy Public- State of Florida)
(Signature of 116tary Public- State of Florida )
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE :
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.