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HomeMy WebLinkAboutpermit mrs. peoplesAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Planning and Development Services Permit Number: Building Permit Application Building and Code Regulation Division Commercial 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: PROPOSED IMPROVEMENT LOCATION: Address: 1525 Alld �_W cC T A_AY L12 Property Tax ID #: -fLI26 - 203 . 0041- 000- 0 Site Plan Name: Project Name: DETAILED DESCRIPTION OF WORK: Residential x Lot No. 26 Block No. 0040V9 i5'XlSrJ 16 RWFIW& Sy!�rFM corgPZ& rci y � Ruoarl Fi7,e Si800-rg APW(X71a,41 i)f- tlf��.d�7�/�yT-�t/iy ex,t` uAlb yws5 5/ST E ,>' wAI& &xizy& &qr- /�1I 7,4L6 %1y61,�-- /71/I67cT rn r� Q &VA! zAN yy6T 5�+5XP1 IN5r%FZ/2`'NAiLSr2tf 4(Ei,46;_2�64•S'i"It.4 TAN 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 61 2 Pitch Total Sq. Ft of Construction: 51 Sq. Ft. of First Floor: Cost of Construction: $ 36,600 Utilities: —Sewer _ Septic Building Height: OWNER%LESSEE: CONTRACTOR: Name 9066oe 4 A/Llgj Pe-oF( S Name: (000 t nNo SAoml 11 Company: &H /40/N& Address: 1525- A110 Sii6e-rei9-q Llrf- 9 City: A�'H C(Tq Stater Zip Code: 3 09 0 Fax: Phone No. E-Mail: 906A/,' i2i"0PI`t'S cc) 'q0/_. ccM Address: 3[ 1(-/ � � �`� L� 5-7. City: 7_UA2r State: F L Zip Code: 3H%q Fax: Phone No ig2' 295- 8133 Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-mail GSG� ��MlL©DiNr�SerL(//C%c Cosy State or County License�ni 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. SUPPLEMENTAL CONSTRUCTION LIEN LMI DESIGNERIENGINEER: Not Applicable Name: Address, City: State, Zip: Phone FEE SIMPLE TITLE HOLDER: Not Applicable Name: Address: City: Zip: Phone: MORTGAGE COMPANY: _ZNot Applicable Name, Address: City: State: Zip: Phone: BONDING COMPANY: V,'_Not Applicable Name: Address: City, 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 Counmakes no representation that is granting a permit will authorize the permit holder to build the subject structure which is In conflict lict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structure. Please consult with your Horne Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit, 1 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, accessary 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 innd to obtain financing, consult with tender or an attorney before commencing work or record! a*i—o"0`rN o4ctee of Commencement. Signature of as Agent for Owner I Signature Holder STATE OFFLORIDA STATE OF FLORIDA COUNTY OF M owl 1.14 COUNTY OF. 14,4A T 1AJ Sworn to (or affirmed) and subscribed before me of 4 Physical Presence or Online Notarization this L_( d f 2020 by Name of persori making statement. Personally Known OR Produced Identification Y, Type of Identification Produced—IMLVI A (Signattfre of Ncofry Public- State o F1 0*114L Notary ruPm --- Maria Y Cajachliki My Commission GC Commission No.60341—& � I b), G Expires 12/0112023 Sworn to (or affirmed) and subscribed before me of — Physical Presence or Online Notarization thlse. day of J" 2020 by ,vll%o��� Name of person making statement. Personally Known t/ OR Produced Identification Type of Identification Produced---T✓u �' 11 of Nptlrry PubliyState of rje.N. No" Public 5' Made Y C ajaci` My commissioll ( I No. Expires 12/01120! REVIEWS FRONT ZONING SUPERVISOR PLAINS I VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED - .(;da