HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED � n C�
Date: " �.� �� Pecmit Number. ,/_.UQ6— GIECEIVED
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JA 2 9 2020
Building Permit Application 5T, 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: (772)462-1578
PERMIT APPLICATION FOR: Ce
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Address: 5Q 0 q P�_. pl_ rc.�_ BIV S.
Property Tax lD#: Y3o 1 - (,o5 0211 -ow g - Lot No.
Site Plan Name: Block No. 4$
Project Name:
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New electrical Meter Second Electrical Meter
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Additional work to be performed under this permit-ch-eck all that apply:
—Mechanical ,Gas Tank -,-,Gas Piping ^Shutters Windows/Doors Pond
Electric ^Plumbing Sprinklers Generator Roof Pitch
Total Sq. Ft of Construction: . �i Sq. Ft:of First Floor:
Cost of Construction:$ o0 Utilities: ,Sewer Septic Building Height:
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Name S�te��4rori SWCh a Name: 1. p ,a_q_
Address:,-5q D . =k. Qi2rGP, '3�,V d_;; Company: 104 r A
City: ' Q�',er ' `.1:: , State: +'7l- Address:-3-71: JJ
Zip Code .3!�Is:l Fax:'' City: State: C._
Phone No. (14o`i) LAL4ty- 61tLi4 Zip Code: _4/R VS- Fax:
E-Mai(:S iYoa, 5 w0-1pp0 yv+yv%, A. earn. Phone No '7 V4 11- �-7p
a Fill in fee simple Title Holder on next page (if different E-Mail PQM¢erQ)J 0 J con
from the Owner listed above State or County Dense i�26 C L�ZYSI'ff-
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: 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 AFFIOVIT: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 perrimit holder to build the subject'struaure.
which is in conflict with any applicable Home Owners Association rules,bylaws onand covenants that may restrict.or prohibivsuch
structure.Please consult with.your Home Owners Association and review your deed for any restrictions which,may apply.'
Inconsideration 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 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 lend r or an at_Wrney before commencing work or record' our-Notice of Commencement.
Signat re ner/L e/Contractor as Agent for Owner Signature of t License Holder .
COUNTY OF—
1 i `��^ y STATE OF F -_ _DA ;C -Lwc
Ic
[JVl COUNTY-OF – — -y
S or to(or affirmed)and subscribed before me of S or to(or affirmed)and subscribed before me of
_VPihysical Pre n r Online zation 6PPysical Pres c Online , ization
this day o 20 y this n day of 20 y
Name of person making statement. Name of person ma\kin�statement.
Personally Known OR Produced Identification Personally Known V OR Produced Identification .
Type of Identification Type of Identification .
Produced Produced
(Signature of (Signature of No
v BROOKE LAPLANT, kµy P$•,, BROOKE LAPLANT
?°• ni Notary Public Sta rida
':°• Gn Notary Public State/IQ��FIqq' da Commission No. '�@@Q����++
Commission ;• U1111fan q GG95et�1� -, mission GS 95T6�0
Comm.Expires Feb 24,2024
of °' My Comm.Expires Feb 24,2024
_h National oto 'Assn,
REVIEWS FRONT. ZONING', '-.SUPERVISOR:. PLANS VEGETATION, SEA TURTLE MANGROVE .
COUNTER REVIEW, REVIEW REVIEW REVIEW REVIEW REVIEW
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