HomeMy WebLinkAboutBuilding Permit Applicaiton All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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avoDate: Permit Number: �f
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-- - Building Permit Applicatij,��
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:
PROPOSED IMPROVEMENT LOCATION: p ,
Address: Q a'n /tcCW-4- 54. Z"e_ 3 f4
Property Tax ID#: 3 3 — b 00 00a 0 ' O d 0 3 Lot No,
Site Plan Name: Block No.
Project Name: GoS
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DETAILED DESCRIPTION OF WORK:
044- k S f /2,r0 0-C-k- W
4,60- poo
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FONSTRUCTION.INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
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_Electric _Plumbing _Sprinklers _Generator 4-RoofPitch
Total Sq. Ft of Construction: S Sq. Ft.of First Floor:
f
Cost of Construction:$ TO Utilities: —Sewer —Septic Building Height: O �Z
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OWNERAESSEE: CONTRACTOR:
Name A-' Name: R�
Address: 990 GAWiNl ^ Company: P_R4c,� .4zA R L� C
City: POK. V_(. � State:�l Address:1 1f q SW. 0?oL%'-r_ i C let S/
Zip Code: 94P Fax: CityApR.� State: F'j,�
Phone No. Zip Code: 3 g 3 Fax:
S"(-
E-Mail: M CO /a, w2m: I . U/M Phone No EZ 7 a) OR(a- S)9
Fill in fee simple Title Holder,on next page(if different E-Mail Q 1b Aet qQ @
from the Owner listed above) State or County License C C l 3 ( 307{o
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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SUPPLEMENTAL CONSTRUCTION LIEN INFORMATION
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State: 1
Zip: Phone Zip: Phone:
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FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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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 thepermit 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 1 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
POSTE"N THE JOB SIT BEFORE THE FIRST INSPECTION. IF YO TEND TO OBTAI FINANCING, CONSULT
WIT R LENDE R ATTORNEY BEFORE RECORDING YOW,40ICE OF CQMMENCEMENT.,
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Signature of O er/Lessee ontractor as Agent for Owner Signature of Co tractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 5 a-. L COUNTY OF Sf [4_,r h,
The forgoing instrument was acknowledged before me The for,going instrument was acknowledged.before me
this day of 20_W by this W11 1 day of (0rl-yu ,2070 by
Name of person making statement. Name of person making statement.
Personally Known V OR Produced Identification Personally Known V OR Produced Identification 1
Type of Identification Type of Identification
Produced Produced
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(Signature of Notary Public-Stat a No►ary P�StW 0f ig ture of Notary Public-Stat7� e;00"
pubwcS °�F
c Andrew G ReiffG Reidll
GG 347
Commission No. �� 1� �fal� 2o23 " Com 'ssionNo. 3�1 �arJ� � ioG23�t
~�` , 3
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGRIOVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19
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