HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 51'4z, S. Permit Number: a S-0Qly'
RECEIVED
RECEIVED
MAY 2 7
2020
Building Permit Applicatio .
ST. Lucie County, Permitting
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772y462-1578
PERMIT APPLICATION FOR
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Address: ���� W I a I S 1c,ct s �RD
Property Tax ID#: , (3\ = 0a,� -1 `"0DO .5 Lot No.
Site Plan Name: Block No.
Project Name:
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New electrical Meter Second Electrical Meter
t; i:'. 7.6480
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Additional work to be performed under this permit—check all that apply:
_Mechanical Gas Tank Gas Piping _Shutters _Windows/Doors _Pond
_Electric Plumbing . _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ � � •� Utilities: _Sewer _Septic Building Height:
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Name Name �7��1(ARo �t1550�--is1®2
Address:
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City: QiQ6Lc' Stater Address:
Ci e o>(Ly S`t' .LiAe StateC
Zip Code: �0�,, :. Fax:
Phone No Zip Code: 7 . Fax:
E-Mail: Phone No
Fill in fee simple Title Holder on next page(if different E-Mail \WR s:: .9 Q) 6-)
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 HAVC 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 TITLEHOLDER: 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.0o 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 br prohibit such
structure.Please consult wlth.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 paying,twice for
Improvements to your property:A-Notice'of Commencement must be recorded.in'the public records of St:.
Lucie County and posted on. the jobsite before the first inspection. If you intend to obtain financing, consult
with lender'or:an attorne before commencin work or recordingour 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 Sir. COUNTY OF
Sworn to(or affirmed)and.subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization Physical,Presence or Online Notarization
this`,_day of V.,.k3 20ik% by this a-Aday of..11%0,p 20X4 by
S3byv0 Gt�n,nd1( � Oq-6066\_jy\.0
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 t- L Produced
(Signature of Nota ublic-State of FI' (Signature of . - NS'
DEpNNA MARIE GIVENS :,}' '`': COMMISSION#GG 022023
Commission No. MYC ION#GG 022023 Commission N '� n; aft
M EXPIRES:December 16,2020 = sod o?' Bonded Tmi Notary Public UndeMniters
off: Bonded Thru Notary pubttc Underv+riters
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REVIEWS FRONT . ZONING SUPERVISOR PLANS' VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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