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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED t Date: !' d© Permit Number: C - 0 Or( RECEIVED • ' - Building Permit Application JAN 2 8 2020 Planning and Development Services ST. Lucie County, Permitting Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce'Ft 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT TYPE: PROPOSED IMPROVEMENT LOCATI N: Address: Q� �3 ® '-• In l- 3 Property Tax ID#: Lot No.L Q) Site Plan Name: 0 0 u Block No. Project Name: DETAILED DESCRIPTION OF WORK: t G % 4evh SEQ- U v< CONSTRUCTION INFORMATION: Additio I work to be performed under this permit-check all that apply: ZMechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: �b Cost of Construction: Utilities: —Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name h9 Name: Address: WAIS Is oam-4�1 r w+ Company: City: State:�v Addre s. Zip Code:3 Fax City: a` S State:�C� Phone No. '���'�3`�� Zip Code: Fax: E-Mail: dv_ Phone No ' QI Fill in fee simple Title Holder on next page (if different E-Mail `( OS 1e1nWtAQ>S-h N& 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. 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 YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR-NOTICE OF COMMENCEMENT." Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The IoWing instr rrent was acknowledged before me The f ing instr ment was acknowledggc before me thi day of 26aQby this day of 20:;4)by L Name of bers6n making statement. Name of per n making statement. Personally Known OR Produced Identification Personally Known. OR Produced Identification Type of Identif t' Type of Identific '<n Produced Produced V L, (Signature of Notary Public-State of Florida) (Signature N9$, Vy,,Publi1CA%M dT.FIbffd4E N B' ,State of Florida-Notary Public �� =* •_ Commission # GG Com i� Ip. KAREN S. NIFLSEN 1) Commission Nqy Ge ission E74 4 __° ' _State of Florida-Notary Public �'' P;;�° June 12, 2022 •= Commission #. GG 207484 o.� June 12, RE I SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 9