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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Q-. CV 9 Permit Number: .�` RE FR _ Building Permit Applicatio7 20Planning and Development Services 19 Building and Code Regulation Division nty, Permitting 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMITTYPE: �� PROPOSED IMIFIR&M MENT LOCATION: Address: � } Property Tax ID#: - I Lot No. Site Plan Name: Block No. Project Name: ©ETA LED ©E�SCR�PTION OF WOR+K: PC CO - RUCT10 4NFORMATION: 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: $ tax= Utilities: —Sewer _Septic Building Height: OWNER/LES�SE CONTRA OR: Name Name:�A, ; lAddXre -'e Company: City1(C State: Address: 'S Zip Code: Fax. City: .State: Phone No. Zip Code: Fax: E-Mail•, Fill in simple Title Holder on next page( if different E-Mail 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. S P EMENTAL C�NSTRUCTIO I N LAW I� I✓OR ATtON. 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 AFFIDAVIT: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 TH YOUR LENDER OR AN ATTO EY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." I Al Signatur:FLORID Owner/Lessee/Contractor as Agent for wn Signature of Contractor/License Holder STATE STATE OF FLORIDA COUNTY OF COUNTY OF The for oing in rument was acknowledge before me The forgoing instrument was acknowledged before me this day of 20 by this day of 20_ by Name of person making statement. I Name of person making`statement. Personally Known OR Produced Identification 1' Personally Known' ;pRTroduced Identification Type of(dent" " -on Type of Identification Produced tA Produced (Signature of Notary Public-State of Flori a ) (Signature of Notary Public-iState of Florida ) Commission No. ,�<;aYd�'% KAREN S. M SEN fFlorida-Notary Public Commission No. (Seal) . Commission #GG 207484 i9 OZ. � 0F I I I1 � June 12, 202• _ REVIEWS ISORI PLANS 1VEGETATION •SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Tem.