HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:'& N,
RECEIVED
Building Permit Application FEB •14 2020
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue,Fort Pierce FL 34982 St, Lucle County
Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE:
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:PROPOSE
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Address: 4 _L. k.W A, l
Property Tax ID#: (o o 00- Lot No.
Site Plan Name: A'�'G A xl `r('- (AT 13 g ;Flc 14 CL l/AG6�17o✓»�Nru (,
Block No.
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Project Name: T-«Jr,�7iC 1/;�Cf l �c3 F•�Icam/L'L.VQ 20 nJ 7J QY6 d'lu In
Q:ETAILEDDESCRIPTIONrO'F�WORI< ' '' ''
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CONSTRUCTION INFORMATION°
.:
Additional work to be performed under this permit-check all that apply:
—Mechanicals
Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: r / Sq. Ft.o First Floor-
Cost of Construction:$ Uxi�yties: Sewer V Septic Building Height: /8
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0W;NER'/1 r EE, w,. 4r�r 4 yak, # Try�,� '.� �r M COIVTRAGTOR .F
„.:: :LSd•c,r "•�` Ri�..k'c, : ,ii;ya•s-!:__�
/14 4-�°� `.. � �✓ Name: Z-9 NOL-F,-
Address: .3I W'7 C,unRRzS S 1&F_' D R, Company: 43At4KVIzS
City: Z_ 0, 1;•`M-rT * State:l:L, Address: (n
Zip Code: 'Y& 7 Fax: City:—_ _ Kg R6 P)r_ff. State: r-4-
Phone No. Zip Code: aL016 1 Fax:
E-Mail: fV�� PhoneNo �Y3 3ad�
Fill in fee simple Title Holder on next page(if different E-Mail V&Ak4_V AW 0�Lr-tV /404 -COM
from the Owner listed above) State or County License C GG 1'C> 8a g
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.
SUPPLEMENTAL'CONSTRUC I:ON UEN LAW IN;O;RMATION
DESIGNER/ENGINEER• _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: ri A Name:
Address: Address: /V4 4
City: State: City: f. State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: 14 1114 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 certifythat-no work or installation has commenced priorto the issuance of 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 you r Home Owners Association and review your deed for any-restrictions which may apply.
In consideration of the granting of this requested permit,l 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 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."
ignature of 6wner/Lessee Contractor as Agent for O n r Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLO
rj
COUNTY OF COUNTY C 1.4 vignp
The forgoing instrumerwas acknowledged before me The forgoing instryf►n ;nt was acknowledged before me
this�dayof �cRr�GLlrr►rn .20� by this�fi`tdayof T 200 by
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification !/ Personally Known OR Produced identification
Type of Identification Type of identification
Produced !� e_e_f__ Produced -`" ' _ „•,y
J/
(Signatu a Notary Public-State of Florida) (Signature of -
t Puy!
Commission Commission
U c SO*di i
wan IZOdrIgYQi 4am n
0,p Expires 04/2612022 ,
Ei*el WOMAN
1 • '
REVIEWS RVISOR PLANS VEGETATION SEATURTLE Mi4NGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19