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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r- Date: 2—� '�7� Permit Number: r O�QL RECEIVED - Building Permit Application FEB 2 p 2020 Planning and Development Services Building and Code Regulation Division , ST. Lucie Count - Y, Permitting 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X- PERMITTYPE:� © P � POSED 1'MPRONEMENT LOCATION Address: �� C)-3, � �✓ f 0, Property Tax ID#: e�..�0�• �j� )• ®Q©$• Q�•3 Lot No. Site Plan Name: Block No. Project Name: DE AfLED DE1��RtPTION OE WORK: 010NSTRUCTI8I HORM�4 ION: Additional work to be performed under this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping —Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generato"r _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ '6no`t- Utilities: —.Sewer _Septic Building Height:. OWNER/LESS E. - CO TR CT0R: Name2 iv1 Name: Address: �— Company: = _ City: SII' 1 =KLV-(L-- State:-_!�-� Address: Zip Code: ? �� Fax: City: ;State: Phone No. O — Zip Code: Fax: - E-Mail: C�Loti.Q �CS(� Phone No Fill in fee simple Title Holder on next page ' 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. SUPPLEMEN AL CONSTRUCTION LIEN LAW E FOR ATION: 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,.perfo"rm 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, accessorystructures,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." I aatr V0 pnr/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE'bli FLORIDA � � " STATE OF FLORIDA COUNTY OF �� , , L1J(�,(� COUNTY OF The for ing instr t as acknowledged before me The forgoing instrument was acknowledged before me thisay of 20?Z)by.. this day of 20_ by L-i At-,i CiR i A mck r Name of lNerson making statement.. / Name of person making statement. Personally Known OR Produced Identification ✓ Personally Known OR Produced Identification Type of Ide tion Type of Identification Produced Produced (Signatur (Signature of Notary Public-State of Florida) KAREN S. NIELSEN Commiss (a =State of Florida-NotaNanAlic Commission No. (Seal) mmission #GG 207484 �Fofi;op My Commission Expires REVIEWS FRONT Z Pfl PERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.