HomeMy WebLinkAboutBuilding Permit Application f
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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Building Permit Applicat on JUN 0, S Z0'o
Planning and Development Services Pe:-rn i-i'li n'g n t
Building and Code Regulation Division Commercial F es' .641*51 E
FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772)462-I578
PERMIT APPLICATION FOR: C-20rocic Door
PROPOSED IMPROVEMENT LOCATION,,:
Address: SL40H Buchanan Dr. Fort Pi ace, FL 3LI6192
Property Tax lD#: Lot No. 3 Ll
Site Plan Name: Block No.
Project Name:
�DETAILED DESCRIPTION OF WORK:17-
Re-placinq nnsfjnq 1l ci qcir-otoc door vy/ I rnpa cf roftr-d
1(otj I+AAS qClroo-C cloc)r,
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
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:
OWNER/LESSEE: CONTRACTOR:
Name C--6r\) pC,-_trspn Name: ISSCIC 20rICA
Address:SLIoL4 e>uc_hctnctn [Dr. company:A-TCCh &Glraac 'Poors
City: Fort PiCf-C-C, State:E L Address:70 EXADY.th MY&
Zip Code:3qG1 92 Fax: City:+-"brl- Si- L-LAOC —State: T--L
Phone No.*1-72-- STI- 0339 Zip Code: 2)LA2.S2 Fax:
E-Mail: qf) bC1 ISOuth. n Phone No 1'12- X28 G114 2- 1
Fill in fee simple Title Holder on next page( if different E-Mail 0tr_Ch!Qalr-0'Q-r0l0oY' (34zLVYNrf0Il-
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from the Owner listed above) State or County License 'J292APY
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.
SUPPLEMENTAL CONSTRUCTION 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 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 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 attorney before commencing work or recording our Notice of Commencement.
Si nature of Owner Lessee Contractor as Agent for Owner Si nature of Contractor/License
g / / g g Holder
STATE OF FLORIDA (� STATE OF FLORIDA COUNTY OF
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pm to(or affirmed)and subscribed before me of Sw,prn to(or affirmed)and subscribed before me of
Physical Pre nce or Online Notarization Physical Presence or Online Notarization
this day o 2020 by th'` day of / 2020 by
00i ON.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
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(Signature of NooryPublic-State of Flori ) (Signature o 0
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REVIEWS OR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.