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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: a 00 6 ©3 ©a [giro D Building Permit Appli ation JUN102020 Planning and Development Services P rmil-t;rlo Building and Code Regulation Division Commercial KesidPUrltlal J 1. L 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR:�ee�j W _s�lr�� PROPOSED IMPROVEMENT LOCATION: ���� Address:8 3� Ce.61,1e5 of N. PA P"'e/ o, pt. 3Y9Y.5- Property Tax ID#:_a3a6 OO( 000-0 Site Plan Name: Project Name: [riq DETAILED DESCRIPTION OF WORK: 0 // nt Lot No. 6 / Block No. .hst_ epjgfNa,� 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: O Ar, Sq. Ft. of First Floor: ® Cost of Construction: $ ,� JrJrJr, opia Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Y-rr Name: LChmI`S A/Q,9/r Address:jG 3a -(a 1 i°y Dne D^, Company: /�irfyYi�urvl,'ADL„I V City: -Ff. Pl'-r 'r 1P State: fLr Zip Code: 3yGi yS Fax: Phone No. 775 — 3 / S — / E9 7 Address: 3317 5, Vi Mrr,io% 51, city: pnr� tip, tuerle I State:E� zip Code: 3 it y S 3 Fax: Phone No 772- 5_d / - 6ao'/ E-Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail d A et 2 ke A na/ �/, ('OHR, State or County License WO It 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 Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLEHOLDER: _ Not Applicable Name: BONDING COMPANY: _Not Applicable 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 attorne efore commencin work or recordin our Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent for Owner Sign re of Contractor License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTYOF J?- /MCJC• COUNTY OF LVCie— Sorn to (or affirmed) and subscribed before me of Physical Pres ce or Online Notarization S o to (or affirmed) and subscribed before me of h Ical Prese ce or Online Notarization this L day of 2020 by this ay of 2020 by enn is e. T t ao"� Name of person making staifement. Name of person making stat nt. Personally Known OR Produced Identification TL ft, Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of I'c- a F r'd re of No ary PuREI i Commission AUDREY .HUm PHRE:YANIE NO. OMMIS�9fGG Commission No JOHNS 300817 �$�� Not ,r u iC •State of FloridaEXPIRES: March 6,2023 � tommisslon M GG t4E504 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATU T E A COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.