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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE.COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ow Permit Number- 002y . n �G�lir Building Permit Applicati n ;-Int Planning and Development Services Building.and Code Regulation Division Commercial ResiderItial.__ — -- 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (77 2)462-1553 Fax: (772)462-1578 PERMIT APPLICATION FOR: 4/1 0 � 1 Vi-FWA P ■[ ER rte iC H 3 4£ d1 Address: yge S ir / PAP,n�SA Vb- �5L , 3 YR83 PropertyTax ID#: " S,,3D ©O/g , 000- a Lot No. _ Site Plan Name: 4qi✓E Ile PARK — om 1 T Block No._� Project Name: IJETA LEQ DES�R! eT Ql a(7�F1/DR F'Y Q 4f11-D4AJ1N(10 I>AlVe, 10p\1 S&e- II'AAKAM 010-K 0-aNc*9,1� w ITS- F Br-, New electrical Meter Second Electrical Mete -oA)& r a `ara-'� G E`r`�' t' GEN5TRl1CTlt tNOtMAT1t3N ?s 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: Sq. Ft. of First Floor: Cost of Construction:$ ©�.DQ Utilities: —Sewer _Septic Building Height: gm "k ' }z ^•fir v , QIYERLJS � i 3 tz $� NTtAGTQR J Name �VSw Name: A) Address: y/(o AIJ4A-Af-) sI4 Company: City: fifer 15AIAI,'r I VCI*, State:VL Address: Zip Code:?,41Q? Fax: City: State: Phone No. S� o�5y 5007 Zip Code: Fax: E-Mail: r f7a SMrn \^^p A'fiT%NfI", Phone No Fill in fee simple Title Holder on next 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. AVG' a n ' 4 E T L N ' kt t✓T } � A tt I77 CRM,AV ' .��`s.*t,. .� ,_�.. .•:_: .o..,'�<'.: ....ss._.,E.,-..�kr.e?.o s". ... �i. .:,a N' 'hx'ir. DESIGNER/ENGINEER: . Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: XNot 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 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 witK any applicable Horne Owners Assodation.rules,bylaws or and covenant�Ahat 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-r.'espeets,'-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 attorne'"before°commen cin work or recording our Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA4, - STATE OF FLORIDA COUNTY OF COUNTY OF .i Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed) and subscribed before me of Physical Presence or Online Notarization Physical Presence or Online Notarization this day of 20_—!>Vby this day of 20_ by Name of person making statement. Name of person making statement. Personally Known' OR Produced Identification r Personally Known OR Produced Identification Type of Identification Type of Identification . Produced Produced (Signature of Nota r ublic-State of orida ) . (Signature of Notary Public-State of Florida) .•k�:Ye�-'' AUDREY PHREY ` �o• G� � Commission No. COMMIS ONJGFIREY 7 Commission No. (Seal) EXPIRES:March 6,2023 — o c n•emvn ers �tv�mzacvrwm "". REVIEWS FRONTy~ ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW . REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.