HomeMy WebLinkAboutBuilding Permit All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 2-0 la-1
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Building_Permit Application
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:
N k•7 � 'S ! L'"�`5 S 4A T` � ' 3 �'d"t-' .'�S 1\ � 11 y}F*� 3 f. S�� F��
Address: �- �G)°�C" '1 S CEJ 11 Y �a -
Property Tax ID#: -33-3 q ` 50 (0 C) -7.5 ��Q ` Lot No.
Site Plan Name: Block No.
Project Name:
New electrical Meter Second Electrical Meter
7-2
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ET1C3 2 "'A
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: Sq. Ft. of First Floor:
Cost of Construction: $ C>c> Utilities: _Sewer _Septic Building Height:
O W Itl ER�LESSE E s� � ` '; � CT4Q t�'•"`K�''�`��-�- �,'� ��� c.�
I
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CES A R
Name Narrie.
Address` �Z C���+cF'ra�ts cloy Company: �f f-4 I <5 efull c-C-
Cityc. ^C �i LrJc( e State: f=L: Address: 3 �t���� v
Zip,Code,: L�J 9�'G Fax: City: State:
Z� -t _ C7 C Zi Code: Fax:
Phone No.: P
E-Mail,: Phone'No
Fill irrfeesimple Title Holder on next page (if different E-Mail!L
from-the Owner listed above) State or County License CI=C ,l
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 AFFINIT: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 l 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 attornev before commencing work or recording our Notice of.Commencement:
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder .
iSTATE OF FLORIDA STATE OF FLORIDA
COUNTY OF. ✓+ �, r COUNTY OF
Swor (or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
Physical Presence or_�Online Notarization --moi sical Presence or Online Notarization
this Y-5 20-.7—d by this day of .2074/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 Produced711,4
'
{Signature of Notary Public-St a of Florida). ,`;'g'"�4 {Signature of Notary Public- to of Florida,}
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Commission No:. (Seal} °� ? Commission No. (Se y
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REVIEWS FRONT ZONING SUi PLANS VEGETATION SEA TURTLE E
COUNTER - REVIEW R _ tE VIEW REVIEW REVIEW o )
DATE
RECEIVED
DATE
COMPLETED
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