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HomeMy WebLinkAboutBuilding permit app r 1 � 1 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 61 .b Permit Number: R-05- VE® MAY 14 2020 - � r Building Permit Applicati ■5T. Lucie County, Permitting 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 APPLICATION FOR: PR,@P SED LNP ®Ue-ESM NT L©CAnTIfJ Address: &?0 Legal Description: L W P04 tT I ( ot Z j21 r /x(77- 1517 1 =� Property Tax ID#: 1301 �3 0670 00,0 S Lot No. Z Site Plan Name: p Block No. 137 Project Name:- Setbacks Front Back: Right Side:S ''G Left Side: DETAILED DE�SCR{ TION aF WORK, �. mod'& a-aSS , Form i sari of W'ro -ride 2 e451 Sele O e0 IFs Cmwcf�t� CC3 STR+UCT G1U INfORIVIAT fJN: itiona wor to a pe Orme un er t is permit—crieck a11 t1jat apply: _Mechanical _Gas Tank —Gas Piping _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: '3 Z Sq. Ft. of First Floor: Cost of Construction:$ Z �� Utilities: —Sewer Septic Building Height: OWNER/LE�S`�S�4• CONTRACTQR: Name Name::::*. °; /. _-16U..c>S Address �� if`�A Compan. ::fia City: State: Address Zipr''Fax City: 1�2fc� ,`/State: / Phone No. .S�Z (R&/:L 3 Zip Code: 3gQ4� Fax: Z ( t 9607 E-Mail: Phone No ZO/ 93 730 Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License C$G /2 SSBg If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENT �NSTRUCTI©N LIEN LAW 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 permitto: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 gianting-ofthisrequested'permit, I do herebV 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 financing, consult with lender or an attorney before commencingwore:or recordingour Notice of Commencement. LJ Signature of Owner/Lessee/Contractor as Agent for Owner , Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA_ COUNTY OF L U e COUNTY OF G F,� i The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this ?d day of #Pri( 20 7o by this >d day of AprfA 20 ZO 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 Produced I.-k 0 (Signature o Notary Public-State of Florida (Signature of Nota Public-State of Florida) Commission No. • Pyip a laM fFloride Commission No. ""1� eryp t}iidFlorlde �My ComQmi�ssioonndW 292585 `h KarynG Df�wd�l Expires 02/11/2023 • It My Comtniasiat Ci(3 2292685' w REVIEWS FRONT ZONING. SUPERVISOR PLANS VEGETATIO ;AA GROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW` REVIEW DATE RECEIVED DATE COMPLETED Rev.