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HomeMy WebLinkAboutBuilding Permit Application rw All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: lI 1� 1 a0 Permit Number: - • RECEIVEDBuilding Permit Applicatio JAN 16 '2020 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: PROPOSED IMPROVEMENT LOCATION: Address: Y, ©S PropertyTaxlD#: Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION OF WORK: Y2. Y FCONSTRUCTION INFORMATION: 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: $ yy Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name VV Name: Address: r(. Company: City:� '(1 � 7�_ State:� Address: 1 Zip Code: Fax: City: State: IFL Phone No.'=— 2�q—( �(�?�� Zip Code: 2\� (3kq p Fax: E-Mail: Phone Nom Fill in fee simple Title Holder on next page(if different E-Mail �� s from the Owner listed above) State or County License 13 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. Y SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: 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 "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 YO1JR LENDER OR ATTORNEY BEFORE RECORDING Y OTICE O OMMENCEMENT." Signature of Own r/Lessee/C tra or as Agent for Owner Signat of Contrac License Holder STATE OF FLORIDA STATE OF AfRIDA COUNTY OF c,2-)FA U)10--\e COUNTY OF '!:�:5� . The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this Qday of _)0('N�0r(�__.20 2�! by 'this A�,D day of Y 20_0y Name of person making tatemen . _ Name of person making statement. Personally Known OR Produced Identification Personally Known V, OR Produced Identification Type of ntifi ion Type of Ide ification Produ( d roduced Ignalu're of Notary Public-St g ture of Notary Public-State of Florida ) o4 ° Not Public State of lorida rommission No. r n otary Public State of F or s a ���Q Greer ion FF h mmission No. to a�Isa Greer Bharath My Commission FF 96 OF FL°o- Expires 02/18/2020 _ �� My Commission FF 96270 e "., REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW TDA T E RECEIVED DATE COMPLET ED ev.