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HomeMy WebLinkAboutBuilding Permit ApplicationA(I APPL14BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: A. \�\ \.\°\ Permit Number: 1i \0 a 03�1 J Building Permit Applic tion©CT 17 n1s Planning and Development Services ST. Lucie County, p Building and Code Regulation Division (� 9 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772) 462-1578 OITII71ercial Residential PERMIT TYPE: r-rturu�tvinvrnvvtivicwl wuHuvrv: Address: (� H Val\zA \Cl1G Q� t-`i-��t�QtC�P r-�• S � Property Tax ID #: (,COILot No. I c� Site Plan Name: Block No. )� Project Name: N OF WORK: CONSTRUCTION INFORMATION:, Additional work to be performed under this permit —check all that apply: Mechanical _Gas Tank _Gas Piping XShutters Windows/Doors �( ElectricPlumbing _ prinklers _Generator Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: I (C t 3 Cost of Construction:$ l.R1i6aD Utilities: _Sewer Septic Building Height: Ih OWNER/LESSEE: ". CONTRACTOR: _ Name UJ C Name: lsJo�2 �usv�est . Address:33C�d 5e,16( Company: IsJJ LLC- City: State: _ Zip Code: '1`7"(Q a�6.1- Phone No. i`t a't-(51) — I-L ( 4 3 Address:3300 -�qp nx iPQe Ste, Io 1 City: G 1 Zip Code: a) L(OC)- Phone No �7a—L(S� 1f 1 Cf State: INC. 3 E-Mail: .Do Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mai . don • State or County License \ `rocr c%Sn C] If value of construction is 52500 or more, a RECORDED Notice of Commencement Is required. If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement 19 required. SUPPLEMENTAL CONSTRUCTIQN,LIEN LAW INFORMATIQN: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: ?C_ Not Applicable BONDING COMPANY: _CNot Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to pbtain 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 is in which 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 revie��`.y�our deed for any restrictions which may apply. In consideration of the granting of this requested I do here�ag�2e that I will, in all respects, the permit, perform 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 roams 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 commencing work Or ecorcllng your Notice of Commenceme Si nature o wn Lessee/Contractor as Agent for Owner Signature of ntractor/License Holder STATE OF FLORIDA _ STATE OF FLORIDA - COUNTYOF COUNTYOF Sl-��ci2 The foldPing instrument was acknowledged before me The forgoing instrument was acknowledged before me this �Sday of 111�" 20 ja by this 1 day of � 2041�k by Name of person making statement. Known Type of ldentiflcatio "' KAREN D'0 MY COMMISSION#GG23755a Name of person making statement. FEN D'ONOFRI0Personally Personally Known y{ pd � iy�23755tS �.,���•'a,'' E:lw92 Type of identifcation ust5,2Produced ,; produced otary PubfwUndenrtilers ' PUNc UndewrM1ers .,... BandedThru Nole9' • �,.. l (Signature of Notary Public- Sta f Florida) Signature of Notary Public -State of Flo 'd ) Commission No.o)�iS3�S (Seal) : • a.6' • Commission No.��`/SAS';';?"�"'�&ea�KACOMpaVONOF 0MISSION#G .I' •P`a EXPIRES:August5, nd REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA LE MANGROVE COUNTER REVIEW REVIEW - REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 55S tets