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HomeMy WebLinkAboutCML Bldg Per AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: •r - 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 C/ PERMIT TYPE: Address: -7g0 1 ll B1)re�z_ rG91�bCIV l��l•�% q Property Tax ID #: 1301 60 00L© wQ — 9 Lot No. L Site Plan Name: Block No. Project Name: Additional work to be performed under this permit —check all that apply: _Mechanical Electric _ Gas Tank Total Sq. Ft of Construction: Cost of Construction: $ Plumbing Gas Piping Sprinklers Shutters Generator Sq. Ft. of First Floor: Windows/Doors Roof Pitch Utilities: —Sewer —Septic Building Height: Name /-" L 1Y(f1"&ftFM&- 7 "-G Address: 5$K8' UAJ&W, y CIAL,g- City:.—State: , Zip Code: 3 1-65-1 Fax: Phone No.� 371 - 2313 E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name: TE-AMA! PP414:- Company: bX4,5 fiA/p hlo!-�E! OF Ale TC', Address: 37 5, gay ' lqw City: �2Er State: Zip Code: JfJK Fax: `77�-�5� Phone No -7 7 d- — VIP Y — D E-Mail 7r? �2 State or County License ew, / j-? IYY(D IT value oT construction is tiz500 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. 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." Al AA Signature of Owner/ Lessee/Contractor as gent for Owner Signature of ntractor/License Holder STATE OF FLORIDA STATE OF FLORIDA / ' COUNTY OF ��A.A., COUNTY OF N'T The forgoing instr ment was acknowledged before this � day of 20 by s The forgoing instru e t was acknowledged bef his 7 day of 202Wby 40 Name of person making statement. Personally Known '� OR Produced Identificati n Type of Identification �+ Produced �Z . Name of person making statement. Personally Known ✓ OR Produced Identifi tio� Type of Identification �+ ct , Produced (Signatu a of No r Public- State of Florida) '�� Commission No. �0.12— (Seal)*�tr' (Si ature of otary Public State of Florida ) Commission ;N"A is (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 2/7/19 Doors & More of the Treasure Coast, inc. 841 S Kind's Hwy Ft. Pierce, FL 34945 P: (772) 409-4501 F: (772) 252-4633 ,vvwv�.d �m -Lii� ._ _Qe c� Name Addre,< Phone 6 1 5 E-mail Door Size *^ Model S4w,Windload '421—Tg Color: C White -,,Almond Brown $ $ - - ----- Re hook-up motor: Yes 00 Trim: /Ye§) No Color: Additional parts: A/�Js 41) 9 Tax $_ Permit $ Deposit $ 4 TOTAL $ Accepted by Customer Date-,-, Signature