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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: !s � 'a a Permit Number: 70(9?�-, QP-57, ihi;y[HVIED J AUG 19 riG20 Building Permit A vlication IT. Lucie County, Permitting 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 1. PERMIT APPLICATION FOR: �_ as aA e Address: �i`�(} IV �il.(911 014_j-0_h t W.5J1J .15fA Property Tax ID #: 1(_)a J - 0 I ' o 1 LQ 7 "Igo- Lot No.�•� _ Site Plan Name: Block No. Project Name: my s-�i he New electrical Meter Second Electrical Meter Additional work to be performed under this permit -check ail that apply: _Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors _ Pond _ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: �y� Sq. Ft. of First Floor: Cost of Construction: $ 60 0 Utilities: _Sewer _Septic Building Height: C3VIfNER/LESSEE'6 m CCJNTRACT4R Name�c,��•`�rQ. Si����/ Name:)&e`U�i1ri 1UiC DIS q / •�Add•ress:43©( �/U WN /Vtfk7Cht^IuSooD 151Aty�' " Company:l1l` YLX-:"A`�� �c�.►w�.� C_ City: b f=ar p i Z: rye State: Zip Code: 3i1� 4 Q Fax: Phone No. ITQL.330L- orloo Address.-3 q6 SCE .5��{l i !►�C •City: P�9f+::,+ Stater Zip Code: "�LJQS3. Fax: Phone No`7')a-ay3-`11OL-a- E-Mail:__5Ub4i e-;5ijk�yj w. COnn Fill in fee simple Title Holder on next page ( if different from -the Owner listed above) E-Mail An i XX !tl 0-1 mo_i L . C[7hr. State or County License S1. L - 3006ct 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. s 114 .,. 4#,' C.a.. d..,_ s�ny_zG 1 b ri AaE '�k.- 7 ka 5W. 'i,�fi r ..CIS.'. ., n�. K . DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: \,4 Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone - FEE SIMPLE TITLEHOLDER:. Not Applicable BONDING COMPANY: �D 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 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 restrictionswhich'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 -..,;+h lonrlor nr on nttnrncv hnfnra rnmmPnrina work nr recnrdine vour Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder . STATE OF FLO A \(x STATE OF FLORID ` UC` COUNTY OF l COUNTY OF \ S to(or affirmed) and subscribed before me of hysical Presence or Online Notarization Swoto (or affirmed) and subscribed before me of Physical Presence or Online Notarization day of V= 20`0 by thi;rn 0 day of c)V 1�,f 20 aO by this Q\Ax W t Cw l S Name of person making statement. Name of person making statement. n OR Produced Identification � C_ PersonallItifi Personally Known OR Produced Identification �� L Type o Ida ion Type of Identificatio Produ d Produced i re of Notary Public -State of Florida.) (Signature of No)tary Public -State of Florida) µY �ors ,P,usBOW, ALYSSA A.T. BOW Commission No. al Commission#GG29mmission ER 1":AYSA A.T. BOW 9�{p�1 Nam? Commission#GG2 �w,FOPFto��or Expires January 28, 23 BEdPiresJanuary28, F O REVIEWS FRONT ZONING- SUPERVISOR PLANS' VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 5/b/20