HomeMy WebLinkAboutBuilding Permit Application A-,
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Can Permit Number:,.2_ ,(9n _0 Lti�
RECEIVED
Building Permit Application MAR 0 5 2020
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address: 01GOC)
Legal Description: _cc e n �7
Property Tax ID#: C)L _C) Lot No.
Site Plan Name:
Block No,
Project Name:
Setbacks Front- Back: Right Side: Left Side:
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AdditionalWOrKtopeperformed uncierthis permit—crieCa
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Electric Plumbing OSprinklers FIGenerator Roof
Total Sq. Ft of Construction: Scl.Ft.of First Floor:
Cost of Construction:$ Utilities:0 Sewer septic Building Height:
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Name (Ako 15Name!
Address:C1 K2S�Q C) Q.
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City: ('r�ze-_O__ ar State: 'i-6 Address: ice' 4 Cu 1
Zip Code: ZH45 --7 'Fax: City: �c- State:
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Phone No.2,-tom-,73 1 CIE Zip Code-_,!, " L41 D- Fax: f "55-s:,40r,
E-Mail: Phone No. C i S'Ste*
FIR in fee simple Title Holder on next page If differe-rit— 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.
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NEItjENGiNEER: ____Not Applicable ::; • •Mt3RTGAGE CCtMPANY:';~- r� 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:
I certify that no work or Installation has commenced prior to the issuance of a permit.
St.Lucie C4unt�r makes no representation that Is granting a permit will authorize the permit holderto 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 the jobsite
before the first Inspection_ If you intend to obtain financing,consult with lender or an attorney before
-commencing work or recording our Notice of Commencement.
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_Signature of Owner/ ssee/Agent n ure of Contractor/License Holder
STATE OF FLORIDA i44STATE OF FLO PS
COUNTY OF att,�., � COUNTY OF jm nG
The forgoing instrument was acknowledged before me The for oIng instru�m,9en,t,was acknowledgP,,il before me
this 3S day of Ft24 bby this day of �4Lil� 200(,Q by
(Name of ers acknowledging) (Name of person acknowledging)
(Si
gnat Notary Public-State of Florida} {Signat a of Nota ublic-St a of Florida}
Persor,,',,,w, -,,C0MM,,G-'3,74,
CHRISTINgnp �ylentif'ication Personally Known,•�OR Produced.Identification
Typ �lBk�i Type of identification Produced
STATE OF FLORIDA Y
9 KeA gyOUNG
COm •yo� {Seal} Camm1551on No. _ #�' �� MYCOMMISSIONa FF 951069
CExpires$/1912023 oe EXPIRES:April 12.2020
OFF'-Q- bonded firu Budget Notary Serrioes
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS