HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: Permit Numbr:�_----- �
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W_ _1 - FEB 2 5 2020
Building Permit Appliornnitting Department
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Planning and Development Services fit. `UCIe COUnt i ��
Building and Code Regulation Division y
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: �` c e .
Address: `-11
Legal Description:
Property Tax 1 D#: ' 'co Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
A 'LEA y"M
D DSRIPTt�N f3F W 'RK�
10 UP-
Additional work to be pertormed under this permit–c ec a tat apply-
-Mechanical
pp y_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction:: Sq. Ft. of First Floor:
Cost of Construction: $ 1 �� Utilities: —Sewer —Septic Building Height:
Name Q,,Merel l Name:
Address: ) Company:
City: F2ft: State Addres\sr:L21 K G _
Zip Code: I Fax: City: V State:
Phone No. ' �rN CP Zip Code: �0��/ Fax:
E-Mail: Phone No
Fill in fee simple Title Holder on next page( if different E-Mail
from the Owner listed above) State or County License ro
ii value of constructions is 2500 or more,a RECORDED Notice of Commencement is required.
°'DESIGNER/ENGIIEE[t. _Not.Apphcalle MORTGAGE COMPANY: Not Applicable:
Named Name:
;.Address- Address
City> - State: City: State:
_m _ - _
Zip; Phone,.. Ztp-, Phone:
FEE SIMPLE T1T'E HOLDER:: Not Applicable BONDING COMPANY: _N'ot Appi cable
r ,:.Name Name_
'.Address:: - Address
City: -
Ip Phone: Zip: Phone
OWNER/CONTRACTOR AFF[DV[T:.Appiication is here4y made to'obtam a permit to do_the'work and iristaQation'as;indicated.
I certify-that:now,.orkor installation has.commenced prior to the issuance of a pei•niit:
St;Lucie Counttyy makes-no;representation that is granting,a permit wiff authorize-the permit-holderto:-build the subject;structure
which is' iH-conflict;with any"applicable Home,Qwners Association rules,,bylawsor and`-ovenantskthat may-restrict or prohibitsuch I
structure:Please'consult.wrth y"ou�Hoine',,owner's Assqciation and review,your,deed.fotad restrictions whish may apply.
m consideration of the'granting ofthis-requested permit,9:do hereby agree that[will,in alt;respecEs,performthe work
:in accordance with the:approved•plans,the:Florida Building Codes and-St'Lucie County.Ainendments.
The following buiidin : e_rrriit;applications'are ezempt,.frorn undergaing a,fulLconcurrency review:room additions;
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accessory structures;swimming<pools,ferices,iivalls,signs,screen rooms and accessory uses to another non-residential use
WARNING TG1 OWNER:Your failureao:Record a Notice of Commencement may:resuit in:yourpaying.twice:for.
improvements:to,your°property. A�Not'ice of.Commencement.must,-be.recorded'-and_=.posted on the:jobsite
before'the,first Inspection: I#yoU intend"to obtain financing,consult with I nderor an attorney before.
•commencln workbr recordin our Notice of Commencement.
Sign - °__e�of Owner/'L'essee�Contcactor-as.Agent for Owner Signature of'Confractor/License Holder -
..STATE70F FLO STATEOF�'AI
COUNTY OF= �a c� COUNTY'Q tA,
The forgoing instrument was acknorvledgefore me TFi'e far ing'inst u' ent was,acknowledged"before me
S
t day:of t r' 20.. by th" day of 2( jby.
(Name of personacknowledging:): (Name of.person acknowledging_) ,
Jr
E (Signature of.•Notary Pubhc St to of Flonda') oit
t5ignature:-of Notary PubJrc state of Florida ? �?,, -
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t ' Personally Known ::_ OR Produced-Iden i Personally.Known OR Produced Id'enti
Type'of Identification �"o off_ Type"of{denUfication m °'
cn-N: U 3 d.-ro
Produced_.- _ "aN Produced'
y .. Commission No. {Seal �v a Gommiission
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REVIEWS FRONT ZONING, R PLANS VEGETATION-. SEA-.TURTLE
NGROV, "
COUNTER REVIEW REVIEW " REVIEW REVIEW:
-DATE _
�i RECEIVED
-DATE"
COMPLETED..
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