HomeMy WebLinkAboutBuilding Permit Application All APPLIC4BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dater 1� `2� Permit Number:
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RECEIVED
1` �T� MAR 2 4 2020
Building Permit Application
Permitting Department
St. Lucie County
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:
. ' ?IONNRMNO ,vOTAT{PROFOSECrI
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Address: S
-k-t 12 Ir �'1 �.
Property Tax ID#;31 --�2^ 4c-D "C�`F" ��—q Lot No.
Project Name:
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.CONSTRUCTION'1NFORMATIO,N
Utilities: _Sewer _Septic` i Sq.Ft.of First Floor:
Cost of Construction:$ 1�U_ ►� �� Total Sq.Ft of Construction:
.,.�"��� W�&.",y E 1 0# � ., 4. $.w;75�yr� � `� �1 ax> x>'" ." '�,�°="x���x+r¥',... '� WfiA°"�"���5^a�y�" �ywule�aa9"�,' °,p�,...y �
�FLOODPLAIN�DE1%ELOPMENT-PEk' ITlbf—structures`ek¬`from?BuildIng, Zbde.,that are�in'�the
floodplain `
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T^ e
Non.resldentlalFarm,Building. F" ^ ° em
Bldg:/Shed°usetlexcluswelyiforconstruction „ `
Mobile/Modular'for�temp construction office n. Bldg involved in�distrib�of electricity. -, � `
Oth'er:" W >' - Flood Zone: BFE $` Floodway?Y/N �
No;Rise Certificate with supporting data attached?Y/N �"', ;,�'
^""'d' ,C. .
All:ottier'a Ilcable state a`nd federal° ermits°slia111,beobtained rior tocmen ement�O'f
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OWNER/LESSEE: : �` '" ', CONTR`ACTOR � N ,
Name_ Name
AddreZ- Company—:2CcL P vi�L
City: _ State:�C—A AddrM(4
5�Z-O Y N_- ,J
Zip Code: 2- Fax: City: \ C=tk_ Stater
Phone No.q" `\ L\kc)- V-1 N Zip Code: LP Fax:
E-Mail: Phone No� _31;�011_�S
Fill in fee simple Title Holder on next page(if different E-Mail (G 1 C�_raC�t�X52 1L-e-c-D CCY YL
from the Owner listed above) State or Ccknty Lic se E(QaZA
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.
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SUPPL� EMVIENeTSAL� v CONSTRUCTION.II•EN•LAW INFORMATION.. M.'
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPA Y: _Not Applicable
Name: Name:
Address: ;Address-
!ty.City: State: State:
Zip: Phone Phone:
FEE SIMPLE TITLE HOLDER: _Not Applic a BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
OWNER/CONTR. OR 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 thepermit 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 Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financi g;evrrsaitvvith-fend an attorney before
comrrencin wor or recordin our Notice of Com ncement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA1 / STATE OF FLORIDA,,,-,
COUNTY OF i- ��.I/[!%t COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this > day of /. 9 0,& this day of 2 20&by
Name bf person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification 2—
Type of Identification Type of Identification
Produced ProducedAli /
(Signature of Notary Public-Spfte of Florida) IR
',aq 4 Id (Signature cf Notary Public-State o lorida)
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Commission No. (Seal) KO d= ommission No. (Seal) •'+�0�
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REVIEWS FRONT ZONING SIS JPEVIEW
LANS VEGETATION SEA TURTLE MAT
COUNTER REVIEW °' REVIEW. REVIEW RE o 0
DATE N3
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