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HomeMy WebLinkAboutBuilding permit app Aug 12 20,02:27p p'1 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO SE ACCEPTED Date: �'� ' �J Permit Number: V �/� • Building Permit A lication 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: svl�: ) �6�& PROPOSED IMPROVEMENT LOCATION: Address: �63cqb.usw © c� 1.—C?Gt Property Tax ID#: • c 1,60 t7 Lot No. Site Plan Name: Block No. � Project Name: DETAILED DESCRIPTION OF WORK: A�-O Q,4 V ox-T eA F' 6 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 Ili Pitch Total Sq.Ft of Construction: Sq.Ft.of First Floor: Cost of Construction:$ _� `4- Utilities: _Sewer _Septic Building Height: OWNERILESSEE: CONTRACTOR: Name ,rr Name. ` � Address: b ompan . `J $ Qua City:' State: Address: Zip Code: , Fax: City: Qa nP.y Q _ _- _ state Phone No. Zip Code: Fax: E-Mail: Phone No D Fill in fee simple Title Holder on next page(if different E-Mail e 1 from the Owner listed above) State or County License CCr I 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. Aug 12 20,02:27p p.2 SUPPLEMENTAL CONSTRUCTION LIEN.LAW INFORMATION: 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 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 priortothe 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 Nome 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 attorney before commencing work or recoriling your Notice of Commenceme . A4 Signature of Owner/Lessee/Contractor as Agent for Owner i tractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF AA 6 Sworn to(or affirmed)and subscribed before me of S,:jorn to(or affirmed)and subscribed before me of Physical Presence or Online Notarization P sical Pre s ce or Online Notarization this_day of .2020 by t is day of v 2020 by I � 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[dent ificati Produced Produced (Signature of Notary Public-State of Florida Signature Notary Public- a RpHda) LMJD/lGltAVIs •• " isultairGG2453fi7 Commission No. (Seal) Commission No. t ��(S�AUWAS.2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. I