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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST Be COMPLETED FOR APPLICATION TO BE ACCEPTED Date:2A-6,A-r),(n Permit Number: RECEIVED 2 5 ?Q20 Building Permit Application FEB Planning and Development services ST. Lucie County, Permitting J Building and Code Regulation Division 2300 Virginia Avenue,Fort Plerce FL 34982 Phone,, (772)462-1553 Fax:(772)462-1578 Commercial Residential PVRMIT PE: 5ZO-7 LA)'111 p a+w1D rt-4r44k N M ... .......... Address: 'teab Property Tax 10 Lot No., Site Plan Name, Block No. Project Name:. Wn' .Mo �N (11 ho aw\)p f'%r Z% 4 Mg' 'A*04 affl,"'if NOME ME Additional work to be performed under this permit—check all that apply: _Mechanical Gas Tank Gas Piping Shutters Windows/Doors Plumbing Sprinklers Generator Roof _Pitch Total Sq,Ft of Construction: Sq.Ft.of First Floor. Cost of Construction: Utilities: Sewer Septic Building Height: r S'. a NameLl%x4j�u A Name- 61� 5 C, Address: Company: WCA r%, e6rtc. -&L, City-, State: Address: Vt Zip Code: Fax, City: Stater ,* 0 Phone No. J Zip Code- Fax: E-Mail: i Phone No e)4,(J Fill in fee simpleyirtle 14 of der on next page(if different E-Mail- �J{l -J 'Lift from the Owner listed above) State or County License— If value of construction Is S25D0 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. x��v� :V� ,;j�'�w :;.,�, t,t' �:c--.ijP � ;:r••4 DESIGNER ENGINEER; Not Applicable MORTGAGE COMPANY: Not Applicable Name•' Name: Address: Address: City, State.• :City: State: Zip: - — Phone Zip: Phone: FEE SIMPi.E TITLE HOLDER: Not Applicable BONDING COMPANY: —Nat Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip, _ Phone: OWNER/CONTRACTOR AFPIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated, (certify that no work or'installation has commenced prior to the issuance of a permit. St.Lucie Count makes ho representation that is granting a permit will authorize the permit holder to build the subject structure which Is in con7lict with any applicable Home Owners Assoction 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 PROPicRTY. A NOTICE OF COMMENCEMENT MUST BE, RECORDED AND POSTED ON THE JAB SITE BEFORE TRE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMIFNCEMENT." LL" jW-7 - S_J,OW Signature of Owna see Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FCQIttO7�'K` �` ► COUNTY OF ORIQA COUNTY OF The or oing instrpment was acknowledged before me The forgoing instrument was acknowledged before me this 0 qday of Kdad 2p1 by this�ay of, 41 c. 20a by Name of person making st ement. Name of person makings ement, Personally Known OR Produced identification Personally Known _ OR Produced Identification Type of Identifica '© Type of identificatio ProducedProduced — I. NOtAttY P1iM7of J lig{' (Signatu a of Notary Public-State of F t�tyCommkmiori a Notary Public-State o r ExDlrets QB127t 2 April Newman ii ��}}�}��� 4h My CGinmitElORG 21141 Commission No, y1�-f do o 0.6& ip al)Expires0&17/2022 REVIEWS FRONT ZONING SUPERVISOR PLAN'S VEGETATION SEATURTLE MANGROVE DATE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW RECEIVED DATE COMPLETED ev.