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HomeMy WebLinkAboutBLDG AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 97. [LUCE1,19 IF " ; o 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: PROPOSED IMPROVEMENT LOCATION: Address: 16A S- Q 5 � n - n c p11T. Property Tax ID #: si 1 • ns 00©� - c:x Q ^ $' Lot No. Site Plan Name: W)✓►cJ V, �kc_ c (L_ b l Block No. Project Name: i.yrnrl rno G t7L t — I DETAILED DESCRIPTION OF WORK: I 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 Pitch Total Sq. Ft of Construction: / 6X, Q cC Cost of Construction: $ `/3 5 Z9. OD Sq. Ft. of First Floor: Utilities: _ Sewer _ Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name/, /, q/, i� r s r a /,,, !G'/ .asc Name: RAY C. APPLEBAUM Address:/Ci9S/ S o,e Ar Company: DRIVEWAY MAINTENANCE INC. City: Jeac; 8,1, State:r�!_ Zip Code: *4 7 Fax: Phone No. Address: 1100 NW 73RD ST City: MIAMI State: FL Zip Code: 33150 Fax: Phone No 786-568-5004 E -Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) E -Mail Permits@ddveway.net State or County License 23500 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 LAW INFORMATION: DESIGNER/ENGINEER: Name: _ Not Applicable MORTGAGE COMPANY: Name: _ Not Applicable Address: COUNTY OF Address: Swovn to (or affirmed) and subscribed before me of City: Zip: Phone State: City: Zip: Phone: State: FEE SIMPLE TITLE HOLDER: Name: _ Not Applicable BONDING COMPANY: Name: _Not Applicable Address: Personally Known OR Produced Identification Address: Type of Identification City: Produced City: Zip: Phone: coo r , Commiaabn GG 2a Commission No a92H 23G `/ I w�yy *xprs 10n2r2ozz 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 thepermit 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 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 R OWNE our failure to Record a Notice of Commencement may result in paying twice for mprovements to yo r property. A Notice of Commencemen ust be recorded in the public records of St. Lucie County and p ted on the jobsite before the first insp c on. If you intend to obtain financing, consult with lender or a ttornev bef>at�e commencine work or reco dintrviaw lTatice of Commencement. Rev.5/6/20 ure of Owner/ Lessee/Contractor as Agent for OwnernatuG of Con or/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTYOF S- ZLlrjF.— COUNTY OF Sworn to (or affirmed) and subscribed before me of Swovn to (or affirmed) and subscribed before me of X Physical Presence or _ Online Notarization Physical Prese ce or Online Notarization thisc2l—'dayof AUCRUSZ 2020 by this day of 4.1s 2020 by /Z0,6ERs ��bvy� vD J Po c Name of person making statement. t Name fperson makingst ent. Personally Known X OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of NotaIic- State f FJor ) ry�,y q,p;�swu of SY f>� i n ur S f� r of Florida y Commission 9 GG 918607 coo r , Commiaabn GG 2a Commission No a92H 23G `/ I w�yy *xprs 10n2r2ozz om 'ssion No. wa ' My Comm. �j 2023 "'gorMed ti rough Natimil Notary Assn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.5/6/20