HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE IN O MUSTAE COMPLETED FOR APPLICATION TO BE ACCEPTED _ f
Date: Permit Number: `�•
Building Permit App icatiorVAY 1 2020
Planning and Development Services
Building and Code Regulation Division ,r i°9� ir � b ` l
2306 Virginia Avenue,Fort Pierce FL 34982 i�, : FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial R41cl# tt9l__� -.=_---
PERMITTYPE:
Address: et e
Property Tax ID l7.() Lot No.
Site Plan Name: Block No.
Project Name: �/ �� G �r-C>fd 4=e�-
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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:
Name Name: ad
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Addre CoC o
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City: State: Address: Lir
Zip Code: Fax: City: 007 Stater
Phone Cvo' Zip Code. Fax:'
E-Mail: � ) Phone No
Fill in fee simple Title Holder on next page ( if different E-Mail
from the Owner listed above) State or County License
If value of con -ruction 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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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,fenLes,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
PO D ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
VNITH XOUR LENDER OR AN ATTORNEY BEFORE RECORDING R NOTICEmOF COM ENC NT:'
.signature f Owner/Lessee/Contractor as Age or Owtrer� nature of Contractor/Licen Holder
STATE OF FLORIDA STATE OF FLORIDQ
COUNTY OF � •Ll-+[. i e— COUNTY OF
The forgoing-instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20,2Vby this JL day of J77,� 26,�tp- by
Name of erson making statement. Name of,/son making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification `'
Produced ���— . ` i Produced IJ' ec
c _
(Signature of No (Signature of N
Yoe "iJREY B.HUMPHRE YNR AUDREY B.HUMPi•i4tEY v
' . ',•. ;ot; ...a�, �:300817
Commission No. °: 'c'OMMISSKQH�I90300817 Commission No. :_' o MYCOMMISSIOt��k it
'. - - EXPIRES:March`;.2023
'.: o EXPIRES:March 6.2023 :w•
`•''F' :^°r Nota Publ'�eUnderwriters ''Fo'NR ndedThruNataryPublic underwftrs
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
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