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HomeMy WebLinkAboutBuilding Permit Applicationa. All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED .. R Date:Permit Number:, f A� RECEIVED AUG q 9 n2o Permitting Department Building Permit Application st. Lucie County Planning and Development Services Building. and Code Regulation Division COII711T12fClai Residential 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772).4621553 - Fax: (772) 462-1578 PERMITAPPLkCAT10N FOR: lip ».- . Address: T p Alo L_ 0 12 —, _A Property Tax ID #: kA 2(1 a-A%A �' i) Lot No. Block No. . ,Site Plan Name: Project Name: mg r a�x E - ®R,�cl13NE [j,r �IN zv.,..ft"11-,?�.. `Sx. 3? ��tx 34 Jeb Qfu) -,Slab AD Psi 11iAc,�l ',-New electrical Meter Second Electrical Meter ER ; 2. d'•,^'.:FY..i'i "iriE $,ry' hiw ""r"'`S 'N . "#^µ'u , 5'''' 'P'� .� .y^ �g 5. 0,� �"b', n r�'tC.0 ��b a'�4t"y� '}�� t 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: ost of Construction: $ Utilities: _Sewer _Septic Building Height: Mapss li r n e , � ��iyry�� ����y��f[���'i•.,.��_,_"'dr&b'^''� y� ,y.a�'.�w�?.�I�F.��i Je ���¢.wr?�_.a{'.ei'. _�'..:Y'i0. sy F i'� � - -" Name (,yZA Lo /�/jtiy �i G Name: Address: `a, � � 4 IL.c ©/y��� _�� Company: City: 'di) L! \ �12C1' State: Address, i Cit State: Zip Code: �l�� �S! _ Fax: Y� Phone No.. q-4' 6- 5_4! Zip Code: Fax: \, Phone No E-Mail: Fill in fee simple Title Holder on next page ( if different E-Mail ' rom 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. DESIGNER/ENGINEER: .--Not Applicable MORTGAGE COMPANY: — Not;Applicab�e. Name: Name: Address: Address: city:State City: r State ZiPhone : Zip: Phone FEE SIMPLE TITLE HOLDER: Not 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 installatiori'bas commenced prior to thevissuari of a permit ; St. Lucie County makes no representation that isi 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 consultwith•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 andaccessory uses to another non-residential use WARNING TO OWNER: Your'failure.to:Record a lYotice of Commencement may cesult-jn paying twice for improvements toour property: A -Notice of CommellGeirtlent 'must be recorded in the public rec60 C s of st._ Lucie County and posted on the jobsite. before the first inspection. if you intend to obtain financing, consult .:+L. 1 11 , .. .."... I L..,;­ Wnrle nr rarnrriina unt it Nntirp,of Commencement. Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder . STATE OF FLORIDA STATE OF, FLORIDA COUNTY OF� COUNTY OF Sworn to (or affirmed) and subscribed before "me of Sworn to (or affirmed) and subscribed before me of P ysical Presence or Online Notarization Physical Presence or Online Notarization this day of 20_ by this day of , 20_ by Nn Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identifica ' Type of Identification Produced Produced (Signature of Notary Pu icy„ a) . (Signature of Notary, Public- State of Florida ) �� =" °eSrat�,�1 VgUG Commission No. =� �~ Commission No. Seal C0 , ida- HN mis Notar' 'Pi�i �tiP` �lyt �bhi ion # (G3G 2Y Public g - REVIEWS FRONT ZONINSO :. PLANS %RE- VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW 'REVIEW REVIEW, . REVIEW DATE RECEIVED DATE, COMPLETED I Kev. :)/ o/ cu