HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLIcATiON'TO BE ACCEPTED
Date:. Permit'-Num bier:
IVED
SEP 2 9 M0
Bui�iding. POrmit Application
Planning and Development Services ST. Lucie. County,.Permittjqg
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34.982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
13, rz�
Address: 3-3 01 C-6 rt�-P-71 Vd. I::--7L 0of'Y'Le,
-/
PropertyTaxib#: 2-44 Q- c? — 2, fl- (D 66 h Lot No.
Site Plan Name: )9- n Block No.
Project Name:
YleW ce- �A, eO S $ A)
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K
01
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit— check all that apply:
Mechanical Gas Tank Gas Piping Shutters Windows/Doors Pond
41<1ectric _Plumbing -_Sp rinklers Generator Roof e Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ Qg 0 0 Q Utilities: —Sewer _Septic Building Height:
7
N M i N't I a L: 6�%@
0.
Name:
Name AM Tr4/7
Address: -�;VJ k2t,'VA�i
Compainy.-
Address:
City: jc-ML a14CO3r0tMk State: T—L
Zip code: Fax:
City: Ed 0,1i State
Phone No. sy—
zip Code: 'Fax:
E-Mail: WL-i.,-
Phone No
Fill in fee simple Title Holder on next page if different
E-Mail 44.6- LI-114
from the Owner listed above)
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State or County License L (j "ip�
If value of construction is 2500 at 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: of Applicable MCiRTGAGE COMPANY: _ Not•Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable.
BONDING COMPANY: of 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.gr•anting a permit wifflauthorize"' 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 Horne 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 respect5,~perform t_he work
in accordance with the approved plans, the,Frorida Building Codes and St. Lucie County.Amendments.
The following building permit applications are exempt from undergoing a full-concurrencyreview:.room additions,
accessory structures; -swimming pools, fences, walls, signs, screen rooms and accessory uses to another non -'residential use
WARNING OWNER:'Your failure to •Record a Notice of:Commencdrnent m'ay, result in paying twice for -
improvements to your'property. A Notice of Commencement.must be recorded=in the public 'records of St.
posted=on:the jobsite before the'first.:inspection..If.,ypy,intend to obtain financing; consult
Lucie CountW'hh
_— witTi riderattorney" before commencin work -or recording our Notice ofCornrriencement.
Signaf re -of wrier/ Lesse ractor 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
--fir- Physical Presence or Online Notarization _
Physical Presence or Online Notarization
this -XA day of Sc_R:ir 204 by
this day of 20_ by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
'Produced
Produced
(Signature of Notary P lio- State of Flori
(Signature of Notary Public= State of Florida )
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