HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Building Permit Applic tion
Planning and Devel6pment5ervices Permit., ent
Building and code Regulation Division Commercial Residential` `�i o
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2300 Virginia Avenue,Fort Pierce FL 34982
Phone:.(772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
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Address: 3'4 C/g Z
Property Tax ID#: Q�2 0, 6'0 o" ei - Lot No.
Site Plan Name: Block No.
Project Name: girlVeu "
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New electrical Meter Second Electrical Meter �..,'EM.`s..�, s _ _ ry^�e y•td«�7+,,�,..: �.. `=Air.ufi
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:$ ®(y) Utilities: —Sewer —Septic Building Height:
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Name 41(Ot.r`i CLS cw 6� &n-' iC Name:
Address: 26-L4 'ot(--)aV,,L DY- Company:
City: -&rC-e State: ICC Address:
Zip Code: L{�( Fax: City: State:
Phone No. Zcw "_ Cf�aC) Zip Code: Fax:
E-Mail: L)cwi j` 1/ne • CoM 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 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.
DESIGNER/ENGINEER: ,Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: Stater
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 tc 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 nonresidential 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 recordedin 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 attorney before commencing-work or recording our Notice of Commencement.
Sigpa6ire of Owner/Lessee/Contractor as Agent-for Owner Signature of Contractor/License Holder .
STATE.OF FLORIDA STATE OF FLORIDA
COUNTY OF � ^ �-'� COUNTY OF
Sw� to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presenj or Online Notarization Physical Presence or Online Notarization
this day of U VIP— 20 W by this day of 20_ 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 �r ,�� Produced
(Signature of Not r Pu lic-State of Flori • ). 0 (Signature of Notary•Public-State of Florida)
Commission N :oti"""°� AUDREYB.HoMpHnEy Commission No. (Seal)
MY COMMISSION#GG 300817
EXPIRES: a
0.
$f,!:• Bonded ru Notary Public Und writers
REVIEWS VISOR PLANS VEGETATION SEA TURTL" ME ` ANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE "
RECEIVED
DATE
COMPLETED
ev.
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