HomeMy WebLinkAboutBuilding Permit Application Hn ArrL1%.AVLt iiw•U nnui,t tst.LUMPLtI:tU,;FUK APPLIGATIONiTOBE ACCEPTED:. .:
Date: ' a,b Permit Number
.,l Building Permit`Applicati JUN 2 3.2020
Planning and Development Services
Building and Code Regulation Division ST. Lune County, Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-3553 Fax: (772)462-1578 Commercial - Residential
PERMIT TYPE:
Address: 53 58 (16-K4 Ci- S C3✓e .��C��
Property Tax ID#: 10 -' ��7 O g ` Lot No.
Site Plan Name: Block No.
Project Name:.
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Additional work to be performed under this permit-check all that apply:
_Mechanical —Gas Tank' Gas Piping —Shutters Windows/Doors
Electric `Plumbing _Sprinklers ,Generator _Roof Pitch
Total Sq. Ft,of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ Utilities: —Sewer _Septic Building Height:
Name - i C e Name: `�-
Address: 3 YYl r 'c w�. AC Company: Gi
City: State: Address t � �i✓
r y6 -C/
Zip Code; 49 Fax: City: . ccs State:
Phone No 7?9 — 73,5 Zip Code:z (0 e Fax:
E-Mail: Phone No 7 �} -
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 HVAC 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 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 t wilt,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
improve ments.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 attorneybefore commencingwork or recordingour Notice of Commencement.
-Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Halder .
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF 'COUNTY OF 'far
Sworn to(or affirmed)and subscribed before me of Sworn to,(or affirmed)and subscribed before me of
Physical Presence or Oniine Notarization Physical Presence or Online Notarization
this'a. day of�Uv�,R-20 l.d by this --Xay of Vyk 20 a.a 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 0 ti- Produced P L-
(Signature of Notary P lic-.State of Florida) ature of N -----.-__.
DEMNAMARIE IttI NS
Commission No."'dada. MARIEGN oMMISSK?N Q 4
DEANNA �gm issiori No. -d. IRES D 24
.*. ':_ MY GpMMISStON bGGar 16, 424 ' o••o MOW that Notary FubISGUttdetwtltets '
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REVIEWS FRONT CS R PLANS" VEGETATION SEA TURTLE MANGROVE
COUNTER W REVIEW REVIEW ' REVIEW REVIEW REVIEW
DATE
RECEIVED'
DATE
COMPLETED
ev.5/6/20