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HomeMy WebLinkAboutAubrey AppII APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Permit Number: Date: Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Residential Phone: (772) 462-?553 Fax: (772) 462-1578 Commercial PERMIT TYPE: P(U-� Address:IF041�J�����-�J a, Lot No.� Property Tax ID #: �Jaa'a Block No. 14a._ Site Plan Name: M,-; .r* KImmo- Additional work to be performed under this permit- check all that apply: Mechanical Electric Gas Tank Plumbing Gas Piping _ Sprinklers — Shutters Generator Total Sq, F` a� Construction: Sq. Ft. of First Floor: _ $�_�Utilities: _Sewer _Septic Cost of Construction: — Name Address: (0g10 9,10 d r Cite: �I.PXik1_ State: Zip Code: YJ� Fax: Phone No.14o ka- Q 0 --1 oW.4 E-Mail. _— Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Windows/Doors Roof Pltch Building Height: Name: )[I U111`10 WAAKr Company: tul►A G1ttYX�,SG of 1'eiiur� 1�A �PtlSi Address: 110 13 'rQMa��!"--�� b(-` bow City: (n ja,1, fir .✓ PsQLtG� Stater Zip Code: 33 9bl Fax: 3;L 717'`Fa --�L— Phone No -7%a-337''4lf-10 E-MaiISLttm State or County License QO/-)11 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. if value of HVAC is y7,500 or more, a RECORDED Notice of Commencement is required. DESIGNER/EN Name: Address: City: Zip: ---- - -- Phone Not Applicable State: MORTGAGE COMPANY: — Not Applicable Name: — Address: -- City: State:.__ Zip: Phone: — FEE .SIMPLE TITLE HOLIDER: Not Applicable BONDING COMPANY: Not Applicable Name: Name: cable !T Address - City: City: Zip: _ Phone: Zip: Phone: J )WNER/ 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. >t. �ucit l;a�nty lnake.; no representation that is granting a permit vviil auihorize the permit holder to build the subject structure lithich nrsult withp applicable Hlome Owners Association ron andrreviewyyour deed or any restrictions wh which may appllyhlbit such n consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work n 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, cc,�s,-or; structures, sWirming 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 TWFX FOP LM�pnOYEMENTS TO FOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." __7 Signature of caner/ Lessee Contractor as Agent for Owner Signature of Contractor/License Holder SATE "FFLCni COUNTY Cs-__, _ ----- — The F r oin6 ir'st''ulroerit was acknow,eoged .oefore me this l day of 2020 by _(_UJA Name of person rraking statement. Percona!,y Knowr, _- (__- OR Produced Identification Type oil icient-ficat.c-, Produced.._..._ gnatilre ; Notary Public State of Florida "LV& blic State of Florida Commission No. (p Y "'• N Antonelli Ashley h:_ A Commission 21 152970 -__H REVIEWS I FRONT I COUNTER DATE RE_-EIVED DATE COMPL..c.T STATIL OF FLOW ,( ZOU 7Y OF 10u ;or wing instrument wa acknowledgeo before me this_ day of , 20W by na , P Name of person making statement. Personally Known OR Produced Identification iype of identification Produced_.-__ .. Signaturgf Notary Public- State of Florida is Sion No IGETATI REVIEW S REVIEW OR I REVI PLANS W I V REVIEW �_- Notary'Public, State of Florida Ashley M Antonelli e ' FXo i�s 018/2021 W