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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED f Date: . -'� Permit Num er: P--PQ___�.. Y U y e 7 FEB 2, 8 2020 Building Permit Appl cation Planning and Development Services , "' i!L i Q e pmt ient Building and Code Regulation Division , K ,' Co C(� IV 2300 Virginia Avenue,Fort Pierce FL 34982 �----- '�'_ Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential rn r PERMITTYPE: 5Ja,b R ,PO D QWIA EM._ IOCAT1 ; ARPM Address: e amck c . LvA Property Tax ID#:3�� _20 G Lot No. /9 Site Plan Name: Block No._ Project Name: 0 �� Serve at SG.I/a0AP� Club �� F orete 1 f" cAe fi ,fir , �C�G U or yeCmov<p . -o" K C 5`TR GTIUIt C Q NIS IIU; ,@a p �OAM 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 Pitch Total Sq. Ft of Construction: rJ, �• Sq. Ft. of First Floor: Cost of Construction:$ ( j('a a Utilities: _Sewer _Septic Building Height: UkNE I.ES k7QNl'RfC�f�R id— Namer 3 . .. � i x P_ `te-I Name: a e- i �' GAY"t Address: HOD Ck (-U\. Company: (Al H 'C�$"IY'UCfi'IbVI City: 6,M sr. L.L)c i Stater. Address: N G 5_25`& i Zip Code: 7 9 Fax: City:FT Lr vd • Stater Phone No. 96 4 - 7? ^/-7 Zip Code: Fax: E-Mail: Phone No' ��� J�'fQ 1903 ,©3 Fill in fee simple Title Holder on next page(if different E-Mail from the Owner,listed above) State or County License C c r 2;,,' 262 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 Sl7MPRLE(rJfENTAI.CfJN °`iRl1CTION LtEN�L_AW=IIVORMATIO(VR ,2^._>.......a. 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 COMMFNCEMENT 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 CObITOENCEMENT." Signature of Owner/Less C tractor as Agent for Owner Sig re f Contracto is rase Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF .. �,o COUNTY OF OR�v�R D The f r ging instrum t was acknowledged before me The forgoing instrument was acknowledged before me th's�day of — '24�by this day of t�brLc,cv r 20 zo by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known >C, Produced Identification Type of a t! cation Type of identification Produced , . roduce ' ;,�Y.' ,, GEST ERIT ,,,,,� oEslicllat .`• MY COMM I ON#GG 176064 _ � h4Y COMMISSION if GG 176464 y r S:Jantsaty 17,2422 `;- * EMRE& N 17.2422 {Si ure of Notary Publ (Signature of Notary Public __ nrni ( ea) - Commission No. (Seal) ..........•. A REYB.HUMPHREY •< iRES:MarchB, SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE i'ic U •''` REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.77ag ,^110,► ,,,. ^AUDREY B:HUMPHREY,. MY COMMISSION#GG 300817 �. ,u- . EXEIRES:March 6,