HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / /
Date: q-2�-2 20 Permit Number: 2
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Building Permit ApplicatioFST- Lucie
Y 0 5 2020
Planning and Development Services County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMITTYPE:
PROPOSED IMPROVEMENT LOCATilOW
Address: 1tl(,e 4q Ay.0— &Le_ to
Property Tax ID#: a.3� d - d 1 a, d (3 d Lot No.
Site Plan Name: &I—V f-"Jty/s✓� Block No.
Project Name: j
DETAILED DESCRIPTION OF WORK:
I eA2 &eLh0^S cif Qr ai i_ 61 20 Sb cw l2
(� Crt l '� C C�pO S! tcr^ S
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:$2O0.C7 -'CD o Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name P.— - All r/I r.., Name: 3Y L Co
�vt"C�'C Vlu S L6 (�
Address: AV Y'/ flu 49n4-1 l3 Company:
City: /SP1 &tlr e r State:, Address: 27-8o ' ►`A- � /��
Zip Code: ,�d j 11 S Fax: City: Port SF I.cJ.L State: �C
Phone No. 772'-3$0-36 7 7 Zip Code: 3 � 1197 Fax:
E-Mail: Phone No '772- - 216 -/21Vto
Fill in fee simple Title Holder on next page(if different E-Mail --STC-" co^C —a�g, &V S( 0�01 •C��
from the Owner listed above) 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.
SUPPLENLENTAL CONSTRUCTION LIEN LAIN INFORMATION,
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 COMMENCEMENT MUST BE RECORDED AND
POSTED ON TH JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR L56 6i'OW AN ATTORNEY BEFORE RECORDING YOUR NOTICE ENCEMENT:'
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Signature of 04r/Lessee/Contractor as Agent for Owner Signature of tra or/License Hol
STATE OF FLORIDA IDA STATE FLORI A— r
COUNTY OF�� �l`p— COUNTY OF ' ( Ltd—"
The or ing instrum t was acknowledged efore me Th or_gging instru nt was acknowledge efore me
thi y of Lt (— 2U�by thi-U I "day of 20 acknowledge
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Name of person making statement. Name of person making statement. 9/
Personally Known OR Produced Identification Personal) Known OR Produced Identification
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Type of Identific ion Type of Iden0catiggrr�� 11
Produced Produced L
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(Signature of Nota lic-State — ture of Notary Pub' -State of Florida)
TINA M.CICIREL 0 "'"'
Commission N066 ,uf AM.cicIRELLO
) Notary Public,State of F�OAt181 fission N A �(Sei4
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