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HomeMy WebLinkAboutBuilding Permit Application (notarized)All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ____________________ Permit Number: _____________________ Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial ________ Residential ________ PERMIT TYPE: PROPOSED IMPROVEMENT LOCATION: Address: __________________________________________________________________________________________ Property Tax ID #: _________________________________________________________________ Lot No.__________ Site Plan Name: __________________________________________________________________ Block No. _______ Project Name: ______________________________________________________________________________________ DETAILED DESCRIPTION OF WORK: _________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ CONSTRUCTION INFORMATION: 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: ___________________ Sq. Ft. of First Floor: _________________________ Cost of Construction: $ _____________________ Utilities: __ Sewer __ Septic Building Height: __________ OWNER/LESSEE: CONTRACTOR: Name__________________________________________ Address:________________________________________ City: _________________________________ State: ___ Zip Code: ______________ Fax:____________________ Phone No.______________________________________ E-Mail:________________________________________ Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name:_________________________________________ Company:_______________________________________ Address:________________________________________ City: ______________________________ State:____ Zip Code: ________________ Fax: __________________ Phone No_______________________________________ E-Mail__________________________________________ State or County License____________________________ 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. X FL 3-20-2020 X low voltage permit 2900 Industrial 33rd Street 2900 Industrial 33rd Street 1428-702-1501-000-1 Treasure Coast Auto Auction Low voltage electric fence as authorized by Florida Statute 553.793 4000 Davcon Properties LLC Davcon Properties LLC EGD, LLC 5500 Sand Lake DR EGD, LLC Melbourne, 550 Assembly St., 5th Fl 32934 Columbia SC 29201 803-201-1773 dmclellan@amarok.com EG13000510 SUPPLEMENTAL CONSTRUCT ION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address : Address: City: State: --City: State: -- Zip: Phone Z ip: Phone: FEE SIMPLE TITLE HOLDER : _ Not Applicable BONDING COMPANY: _Not Applicable Name: Name: Address: Address: City : City: Zip: Phone: Zi p: Phone : OWNER/ CONTRACTOR AFFIDVIT: App lication is hereby made to obtain a permit t o do the wor k and installation as indicated . I certify that no work or installation has commenced prior to the issuance of a permit. St. _Lucje _Countfl_makes no repre~entation that is granting a permit will authorize the permit holder to build the ,subject str_u~ture w hich 1s m con l1ct with any applicable Home Owners Assoc1at1on rules, bylaws or and covenants that may restrict or proh1b1t such structure. Please con sult w ith your Home Owners Association an d review you r deed for any restrictions wh ich may apply. In consi deration of the granting of this re quested permit, I do hereby agree that I will, in all respects, perform the work in accordance with the approved plans, the Fl orida Building Codes and St. Lucie Co un t y Amendments. The following building pe rmit appl ications are exempt from undergoing a full concurrency review: room additions, accessory structu res, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residentia l use "WARNINC TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYINC 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 FINANCINC, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." ~r-1..._ \ Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of 'l::o nt ijt o r/Li ce n se Holder STATE OF FLORIDA STA TE OF~GftlOA ~ ~L..J/\JA COUNTY OF COUNTY OF L;c~ t-J,(s~ The forgoing instrument w as acknow ledged before me The ~g instrument was acknowledged before me t his __ day of 20_ by t his ay of tuH.U-\ , 20.W by Name of person making statement. Name of person making stat ement. Personally Known OR Produced Identificat ion --Personally Known ~ OR Produced Identi fication Type of Identification Type of Identification Produced ''°V~ (S igoat,ce ~e of -)~µ, \ (Signature of Not ary Public-State of Florida ) Co m miss ion No. (Seal) Commiss i on N~~-rAROL BAw'!JINGER ~\II.~ I NOTARY PUBLIC .. --• -. 1:--"~~· ,,-'-~•-VI ---'"' -·-~:-·n ~i ~GROVE REVIEWS FRONT ZONING SU PERVISOR PL ANS ~ R ,l?20, COUNTER REVIEW REVIEW REVIEW ,~ . .u -REVIEW DATE RECE IVED DATE COMPLETED ~ev. 2/7/19