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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 1 a.T \�_ Permit Number: Al la-461 RECEIVED A 11111F CWFL Ot - Building Permit Application DEC 19 ' 9?9 Planning and Development Services Building and Code Regulation Division ST. Lucie County, Permitting 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: P �OPOSED IMPROU MENT LOCATIO Address: 71a2 e- 1-,4v.e— Property Tax ID#: / 3 O/r lv l� D'/ S-3 — Gds O Lot No. Site Plan Name: Block No. Project Name: D AISLE© DE�SC«R1PTI0 OF ORK: �icJCGJew bgiiAe-r- CONSTRUCTION IN�OR ATION. 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: $ !Jf9, Utilities: —Sewer —Septic Building Height: Ooil WNER/ EANEzE: CONTR_11A OR: Name ��4ia✓r� T f�Ti SCO Name: Address: 7/07, F1_00 J"'1z Avg Company: City: Yoi )�'�r�P State: FZ- Address: Zip Code: 3'r/ f / Fax: City: State: Phone No. 7 2 Z - 3;�'' J g (71-5— Zip Code: Fax: E-Mail: e ��K�,•g`TG __1 Phone No Fill in fee 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. SUPP E off a •ONS T UCTION EIN MI.W mpfflm,710 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 WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Signat r/Le se ontractor gent for Owner Signature of Contractor/License Holder STATE OF FLOR DA STATE OF FLORIDA COUNTY OF_ S��Lyc,�� COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this \4\ day of c 20_J!\by this day of 20_ by Name of person making statem t. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced L Produced (Signature of Notary P is y r"'�Iof FISSION#GG 022023 (Signature of Notary Public-State of Florida ) EXPIRES:December'16,2020 Commission No. 6 Bondeq j�taNPublicUnderwriters Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.