HomeMy WebLinkAboutBuilding Permit Application 7
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r
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Date: ` L' Permit Number:
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PP LuciaCrruP,Ey, perrrlittin.g
Planning and Development Services - -
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Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential -�
PERMIT TYPE:
Address: L ksky)��' .
Property Tax ID#: _00504 ' 0�0 O Lot No.
Site Plan Name: Block No.
Project Name:
I'BEdUNME-
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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: 0 Sq. Ft.of First Floor:
Cost of Construction:$ r' Utilities: —Sewer —Septic Building Height:
C)NT
Name L a l� Name: MAP,
Address: 11-3f C(DIC,^,11 NCA17 7 P C0 Company: MW 1 4 i5IA[�(Z(�
City:� U�C��G'-(e State:TL Address: 2130 04z9VIEW 7�
Zip Code: 3316 Fax: City: 1\12UU Q02L( 0646Y State
Phone No. �u -oZ)4'ry((� Zip Code: `f �?S� Fax:
E-Mail Av,c�^(%�nyS C��Qc_� L ccs-ro c6-rim9- , iiel Phone No �1 Z7� 243 -5
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Fill in fee simple Title Holder on next page(if different E-MailwiN d�le t 00/11
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from the Owner listed above) State or County License t__ c "13q2—
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:j _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 permitl 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>9WMNQWdRA ATTORNEY BEFORE RECORDING YOUR NPITICE OF CO MENC ENT."
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Sig ure o e see/Contractor as Agent for Owner Signatur of Contractor License Holder
OF FLOIAIDA STATE OF FLQWA
COUNTY OF D"N"C,vycd COUNTY OF__X tK5 C_b
The fo oing instrument was acknowledged before me The forgoing instrument was acknowledge before me
this ay of�(QI(Y1 , 20 by this \ day of lk 0 20► by
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Name of person making statement. Name of person making statement. `
Personally Known��OR Produced Identification Personally Known OR Produced Identification X
Type of Identification Type of Identips t'6 L
Produced Produced r +JJ
(Signature o Notary P (Sign ture of Notary Pu
!�''• PATRICIAMNCHACONi'va�-•., ROSEMARIEBOUDREAU
Commission No. M1'C �1310NIIG0361474 Commi Sion NO.
�• fit;= Notarygigt�StateotFlorida
EXPN$;Aug*1�2W Q€ Com ission#GG 144185
oP R r ,,� 01 My Comm.Expires Mar 11,2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.217119
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