HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 0 2 A ZC12Q/ Permit Nu Fr � y
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FEB 19 2020
Building Permit Application
Planning.and Development Services Permitting Department
Building and Code Regulation Division St. Lucie Co 'nty, FL
2300 Virginia Avenue,Fort Pierce FL 34982 t.
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Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE: 'Roo _ C
Address:
Property Tax ID#: V o Lot No.
Site Plan Name: Block No.
Project Name: 6L.EA7-A r2• M&w Zoo T
PER oy,F, S d l k76/E T.0 S i AU- p�/ Z d'L AS P L- '-S f&k mss• 0&Q&1<
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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 112— Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$6,4MA.®d Utilities: —Sewer _Septic Building Height;,
Name FL.g--Ar-/}p AN.NrjmName' ._ .. - _ _ `:" `, `^ •,
Address: /U pita nay}0i Auti Company: ' :.. _ 1 o
City: F02i J2ij52 ��� State: Address:
Zip Code:3 Fax: City: ;~ tState:
Phone No. - Zip Code: Fax:
E-Mail: LLG jdi1%jL.C,,• hone No
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.
i
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 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 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 TH OB ITE BEFORE THE FIRST,INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YQIJQ
WATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signatur f 0 r L ee ntractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA s STATE OF FLORIDA
COUNTY OF—S COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thisJJ1day of FEl3/1�fidP Y� 20_, by this day of 120_ by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification—A/— Personally Known OR Produced Identification
Type of-IderiL•ifi&,ation Type of Identification
ProducedD. Li Produced
.
y Jemrdo Ayala
-(dig t9; 0 (Signature of Notary Public-State of Florida)
EXPIRES.Feb M 5,20
�o m`issiol�N :`• g AM NOWY Commission No. (Seal)
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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