HomeMy WebLinkAboutBuilding permit Applications U 0M\VCk1� 0T-kU1Q
All APPLICAAIBLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �� C
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Date: / -�.�' " -) �� Permit Number
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Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE:
Address:
Property Tax ID #: V
Site Plan Name:
Project Name:
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Building Permit Application � AUG 2 6 2020
ST. Lucie County, Ferm'9
Commercial Residential
0 Lot No.
Block No.
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank
_ Gas Piping
— Shutters
Electric — Plumbing
_ Sprinklers
_ Generator
_
Total Sq. Ft of Construction: I PF
Sq. Ft. of First Floor:
Cost of Construction: $
Utilities: _Sewer —Septic
CpNTRACTOR:; :.
i sOWN ER'; XtSS�E
Nam
l
Name:
Address: 13 `6 C,J �� or, L-
Company:
city:�,�
State:
Address:
Zip Coder j9t Z Fax:
City:
Phone No. CS a l ^ 3-7') W 96 4S—
Zip Code:
E-Mail: I r�%1 o ts� y
k,0—
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 HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
Windows/Doors
— Roof Pitch
Building Height:
Fax:
State:
•
DESIGNER/ENGINEER: _ Not Appllcame
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
ORMATION;
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Nama-
Address:
rity.
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
structure. conflict
leasle consult with your Home OwnOwners
rs AssAssociation
cia Ion landrreview your deed for any restric that
which maor
aprohibit such
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 and accessory uses to another non-residential use
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON "E JQB SITE BETRE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR EN ORAICAT'I'ORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of ner/ Lessee/p6ntractor as Agent for Owner I Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OF
The f rgoing instrument was acknowledged before me The forgoing instrument was acknowle2doged before me
by
thisO� day of a`�`� . 20,E by this day of
Name of person making statement.
Name of person making stateme t.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identific on Type of Identification
Produced L 1. Produced
(Signature of Nota (Signature of Notary Public- State of Florida )
••••"�,,••.,. DEANNAMARIEGr
Commission No.� MyCOMIAB@4N#GG022023 Commission No. (Seal)
EXPIRES: December 16, 2020
::.
%;fo�g4,'�•�' Banded TWNotary PubUcUndeWterD
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW * REVIEW REVIEW REVIEW REVIEW
RECEIVED
DATE
COMPLETED
ev. 27TJ:S