HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q"
Date: 4th• Permit
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Building Permit Application
Planning and Development-Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE:
PRt+7POSE�D M' R01/E�t1lIENT LOCATIry`O,Ns�
Address: - c�2 i"D,i?i e I I SI-2f
Property Tax ID#: 0�`j ��� Lot No.
Site Plan Name: �, i Nl rs V�16�4 �c�iV��! z_� Block No.
Project Name: / ,�.'�r��l��s r rv�zN`�. 4 wN/r2 sr
DTAI'LEQ D58.@R� 12011 N O�W@R��
CONSTRUCTION INFORMATION:
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:$ / U C;v Utilities: —Sewer —Septic Building Height:
O1i NERf LE:SSE CONIT]
RAG/TCIFt:
Name Mt OL'I"� r G _ li. i�z�T Name:. ( F�� l f rc. Ic« 4 46
Address: ? •3 �A; 1> �� rc) Com pan
City: �1, Pr S� i �.� CvState: [ Address:
Zip Code: �L 74X— Y7)q Fax: City: d�JS �r�C,�, State:
Phone No. f` �l(1�� ���� ` ��ari Zip Code: yFax:
E-Mail: `' Phone No.K !22Y—S 6S_(
Fill in fee simple Title Holder on next page(if different E-Mail G i AR f GC 14 /R/i,H G a vas
from the Owner listed above) State or County License �L I
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
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Mar 02 2020 5: 52PM HP LASERJET FAX p. 2
WID) . NGINEER:' „Not App gab a MORTGAGE COMPANY:. ®-Not'Applicable
Name; Name.,
Address: Address,
Clty: Stat;. City: State:
Zip: Phone, Zip. Phone:
FEE SIMPLE TME HOLp91t: _Mot Applicable EOF$DING CON ANYY: —Not Applicable
Name,. Name:,
Addrlslcs; Addrew•
City:
ZIP: Phone: Zip. Phone:
-
OWNER/CONTRACTOR AFFIDVIT,Application is hereby made to obtain a parmit to do the wort;and Installation w Indlsated;
I certify tot no work or Installation hag commenced prior to the Issuance of a parmM
Sth( ei®qua makes no�a�®pre�i� ���that Is "soc>atlo r�aby�er9ze the mit holder to build� ub��t etrt��r®
wit Is In o Ict with an totble ' �� venents that mray,ria et Pro it u�
sts umm.'Please eQW[t VA yoaar Home Ownera_ASsodat lon and r y®,r d jr any restrlcti®ns wivic may apply:
In,wnsideration of the granting of this requested permit,Ido hereby ii;Wltgat Twill,In all reap acts,perform the work
in a cgordance wl#h the approved pian®,the Florida Building Codes and St.Lucie County Amendments
The following building permit appficati009 we exempt from undergoing a full concurrancy revierv:room fadditlons,•
accessory Structures,swlr»mlMS pools,fences,walls,Siena,screen rooms and accessory ups to anothor non4osidential use
"WARMG TA OPP= YOUR IFALUM TO RECCIGID A MW=4W C(WWMZMW MAY Rwwr vi wow PATMIG
TWICZ POR TO TOtO PROFEW. A NOTIM OF COMMIUMNIPff MUST OE RVARM AND
pOISTID ON Tw`jov WM MWOM Till: FRWT VAPUMlRY V YOU IMT!lUO TO OBTAW f WANC I MO,CII711iM&T
M114:YOt! MER go AN&1rTMff 60M WWWW YOUR NOT O OF T"
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Sign of t3avnor/ a/Contras wont for Owner .Fgnawrs of Contractor/License Homer
STATE OF FL,CRII ' STATE OF FLORIDA
COUNTY OF _...e 'COUNTY QF _
The f In"02t eves oeknowied ore me The fo�1Mg nt wee aals�cmvledpd before me
t o 2ty 1 der of
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Nemd#FWrkM Maeidr�s� ent. � Norm of persdnn making moment.
Personally Known 09 Produced Identifir�fon � Personally Known OR Produced Identlf eaten
Type of Idenbffee#1gn Type of 10entikation
Produced t .�'�---^ Pmdviced
(Sigrt m Rlotary Publ wsery Pu I naoare of N iorlda')
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Commission Nei. 4 onvnisel�n Expir mission No. ?' �UMPHREY
2p22 =�: , ;* MYCOM SSION#GG 300817
onded Thru NoW6 Public
REVIEWS FRONT' ZONING SUPERVISOR PLANS VEGETATION
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