HomeMy WebLinkAboutBuilding Permit Application 08/06/2020 THU 8: 31 FAx 7724896541 Jackson oruga pharmacy 1002/009
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED n
Date: -, Permit Number:
amBuilding Permit Application
Planning and Develapment Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMITTYPE; c:/r y w.fFA 1-„Jg
Address: Q( cc EL
PropertyTax ID N: D - - - �- Lot No._..6_4 7
Site Plan Name; Block No._ 0 _
Project Name: vii yalo �i AN»n1
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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:
Cast of Construction:$ _ Utilities: —Sewer —Septic Building Height:
Name 'Z_ Name: Allk
Address: o(? Company: _
City { l`QC cp_ State: FL Address:
Zip Code: Fax: City: _ State:
Phone o. Zip Code: Fax:
E-Mail: t� Phone No
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) i State or County License
kvi III) 0 )V%
If value of construction is 500 or more,a RECORDED AIRtice of ommencement is required.
If value of HVAC Is$7,500 or more,a RECORDED Notice of C encement is required.
08/06/2020 THU 8: 32 FAX 7724896541 Jackson Drugs Pharmacy 0003/009
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DESIGNER ENGINEER; Nat Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: T _ Address;
City: State: Clty: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY; Not Applicable
Name: Name:
Address: 401 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.Lucle Countyy make no representation that Is granting a permit will authorize the permit holder to build the subject structure
which is in conrllct 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 YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT:'
Signature o ner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORKM STATE OF FLORIDA
COUNTY OF gu Q)c c_. COUNTY OF„�_
The forgoing instrur�erft was acknowledged before me The forgoing Instrument was acknowledged before me
this lam. day 20 70 by this_day of .20 by
�_fCA
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identificati n Type of Identification
Produced -20 Produced
SANCHEZ
(Signature of Natar N#Qa0 (Signature of Notary Public-State of Florida)
EXPIRES November 09,2020
Commission No. seal Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 217119