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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number', Z•� � + 1 1 AUG Goy Building Permit Applica %►n,r ; I t� Planning and Development Services r Building .and Cade!Regulation Division Commercial Rest—lal-__;. 2300 Virginia Avenue,Fort Pierce FL 34982y�, Phone: (772)-462-1553 Fax: (772)462-2578 rC"L 1 r✓ r-'D JZ FV- 1 v1ze el e-ok 4f24_"1 PERMIT APPLICATION FOR: Address: L) 4!5- 13 41fkzf4_ Vt s"T4 Property Tax I D#: . f (� "� OOc3 "" !I Lot No. Site Plan Name: Block No. Project Name: e' {T� } �:m �C,' � ��"'�'- f-� ., [ ,��,"i j� k*y"�(��� ,;,;,•c� �F'�:� ����'�� ���,���'�v�c�.�{"`�a`'T � "ice, �: � � .. *l '�'•r yx<. �-�' �:of r � �'Neu 't`=.. '�' xhn � � .,w,°,'.F"'� �+v �.F.�., ``a� � -•"x,.-e 'f 3 �' t�,r�r XA.es^�.-i .. P-001— 16t;, 96 ! clic S ?�7 k ciJ New electrical Meter Second Electrical Meter Additional work to be performed under this permit-check all that apply: —Mechanical _Gas Tank —Gas Piping Shutters Windows/Doors Y Pond _Electric _Plumbing MSprinklers _Generator Roof Pitch ' Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction: $ 00a. &+7y Utilities: Sewer Septic Building Height: Y-�.' A,�yx.:�r�w"^ "yi:cS�r' �ry7� ' E' c�. wjk, '�£ x w; t �,,3C'L;3?:y .i, �� . -`„'.. r.. nw...".'::.n., rf. x,�_.<m.. ...,. .w .e.... '_, s��r...=*' a....e,.:.x..�.,.. .tet. n'&.,., z v..�.©a _�z .h...:a:...,...�...i Name ba Z Name: Address: . S J0Lyo. Company::, City: State: Address: Zip Code: Fax: City: State: Phone No '2- '-- / Zip Code: Fax: E-Mail: L-' C `� t jird Phone No Fill in fee simp a Title Holder on"n-64 page (if different E-Mail from the owner listed above) State or County License 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. i I DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: . _Not Applicable_ ' Name: Name: Address: Address: City: State: City: State-", Zip: Phone Zip: Phone FEE SIMPLE TITLEHOLDER:. —Not Applicable .BONDING COMPANY: Not Applicable Name: Name: Address: Address: Zip City: city.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.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 Horne Owners Association rules,bylaws or and covenants that may restrict or prohibit such structure.Please consuitwith.your Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting of this requested permit,l 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 andaccessory 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 recordedin 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 recording our Notice of Commencement. Signature of Owner/L see/Contr ctor a t for Owner` Signature of Contractor/License Holder . STATE OF FLORIDA �'+ � 1 STATE OF FLORIDA COUNTY OF od l e)"_C4+f, COUNTY.OF Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of Physical Presence or Oniine Notarization - Physical Presence or Online Notarization this )t day of_4 tut.- 20-00 by this day of 20_, 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 4) A, d Produced OAA (Signature of Notary lic-State of Florida}. (Signature of Notary Public-State of Florida} - Commission No. ;'oto Y?i ce. AUI§§6 HUMPHREY MY CO tMMISSION#GG 300697 � Commission No.' ,Seal) EXPIRES:March 6,2023 tiOnOeQ 4 nrUoW]y VUENC Uncerwritern FOAM— REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION- SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.