HomeMy WebLinkAboutBuilding Permit Application AllAPPLICABLE INFO MOIST-BE COMPLETED-FOR APPLICATION TOB E ACCEPTED
Date: i D.-1 ati� Permit,Number: . a0 O 5
REC�:IVEd�
Building Permit 'Ap�alicati n MAY 2 7 2020
Planning pnd:Developinent5ervices ST. Lucie County, Permitting
Burld�ng and Code`Reguld tion Division
230011irg�nia Avenue,Fort Pierce FL 34982
Phone: {772)462 1553
Fax.- (712)-462-1578 COmm2rcial' R.esidontial
PERIVi{T TYPE
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Properfy Tax'ID#:-L41 0 .-Jr'a - Q bc.4 - 660 l .
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Additional wor-k to beN;performed under this permit check all'that apply , :, " ; -
�/M'echanical as,Tank Gas Piping _Shutters Windows/Doors
'�ElecCric ' _Plumbing _Spnnklers Genera"tor Roof Pitch
Total Sq.: fbf Construction Sq-Ft.of`First Floor
Cost of Consfruetion
Utilities Sewer Se tic euildin Wei ht
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Zip Code: Fax: Gty �� faun State: l
Phone-No 6 r%-. 3/-7 e.,�o� �,�
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fail fr fee simple Title°Holder on next page(if different- E-Mail,S a�. :.I^ra C,-�;Y,� 4,,, C�
from th'e Owner fisted- above)' State or County,l cense
if value of construction is$2500-or more,a"RECORDEQ'Notice of Commencement�s regwred
It yaiue bf HVAC is$7 500"or more,e-RECORDED No#ice 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,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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT:'
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF S+ •I--�A G I COUNTY OF S± ,L—k XC
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this l_q day of 20_ by thisday of 2( O by
Tc),v, -T��h Lew ,► .
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known/'vOR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature o (Signature , . ublic-S¢V$ •ENS)
r1N'ro�s LUANN O'CONNOR �, _- Notary Public-State of Florida
y4. Gt
Commission Notary Public-State 4lidsfda Commission � Commission N GG 27t( al)
ommission#GG 270518 y omm.Expires Oct 23,2022
My Comm.Expires Oct 23,2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.