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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: d� _ 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: ' ROPOSED IMF`ROUE ENT Ll7C TION Address: PrbpertyTaxlD#: �I 0DD�6� "6dd Lot No. Site Plan Name: Block No. Project Name: I DETAILED DE=CSC' I'PTI©N {)E WOR+K: \L� I . CONSTRUCTItO �NFOR�MATION: 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 Z, 3 Pitch Total Sq. Ft of Construction: 1(.00 Sq. Ft. of First Floor: J Cost of Construction: $ i Utilities: _ Sewer _ Septic Building Height: I OWNER/L SSEf: C«ONTRACTiv1R: Name Vr� (lu-� Name: Address: Z �{ (\J S� Company: City: Foa-V State: Zip Code: Fax: Phone No. `City:.~' ,,,,,, State: ,..,,.',.• `Phone '.No {E-Mail• 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.. S PPLEMENTA CONSTRUCTI©N LI LAW INFOR DESIGNER/ENGINEER: _ Not Applicable Name: ATION MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: Not Applicable 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." Lo a�o-� Signature of 0 ner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing inst ent was acknowledg efore me The forgoing instrument was acknowledged before me th�_ day of 20by A ), I fwl) A 1, - this day of 20_ by __U�aowz Name of person rQl statement. Name of person making statement. Personally Known OR Produced Identification` Personally Known OR Produced Identification Type of Identifica �' 1n Type of Identification Produced �YL (JSI; Produced (' nat re of Notary Public- to of Florida) (Signature of Notary Public -State of Florida ) Commission No. :,Q`f"YPb �; 1ASq pNGRAM•RAHMING Commission No. (Seal) My COMMISSION # GG 27SWO =�.. . P.�`,.•' EXPIRES: Decembe 2 902 Thru No ry Public Uoderwrllero REVIEWS FRONT ZONING-- _ PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 2/7/ 19