HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED cp
Date: 0- -b-9-o ) Permit Number:
�CEIVED
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� BuildingPermit Application OCT 2 8 2020
Planning and Development Services ST. LucC nty, Permitting
Building and Code Regulation Division Commercial Reside
2300 Virginia Avenue,Fort Pierce FL 34982 `
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR: T
PRQPOSEDIfMPROVEMENT'fLOCAt7"ION - r
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Address: (CLQ < F �ol/I�iA 1�UP4(le
Property Tax ID#: 3y �a' � �� �a`�a- bC3a- a Lot No.
Site Plan Name: Block No.
Project Name:
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�DET�AIYLED�DfESCRIFrrION OF'WORiC �` � x x � �� L� , � �� ��`
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New Electrical Meter Second Electrical Meter
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,CONSTRUCTION INFORMATION , i �� r ra ,
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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: $ 3, S�/ 0 Utilities: —Sewer —Septic Building Height:
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OWNER/LESSEE �; va y i, 4 CONTRACTOR
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Name C« Vq ) Name: 6_5,,ff L
Address: S C_ Company:-» Air
l`t ir .'Sd/UI't`d/I)', LLC
City: V S L--. State:_ Address,: 0.
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Phone No:' —7 Zip Code: v //Fax:
E-Mail: Phone No - f /OV9
Fill in fee simple Title Holder on next page (if different E-Mail SGV fC/��0 I 1��° e?i~ •G�/'``�
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.
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: ^ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone 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 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 with any applicable Home Owners Association rules,bylaws or and covenants that 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 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 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 attorney before commencing work or recording ur Notice of Commencement.
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A A �)/'L'� '
Si a ure,o O nerf Lessee/Contractor as Agent for Owner S" na urVFLO�ntractor/License Holder
STATE 0 FLORIDA STATE �I,DA�
COUNTY OF S-�r . LUc'�� COUNTY OF
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed) and subscribed before me of
sical Presence or Online Notarization Physical Presence or Online Notarization
thisPhybc�
. day of `` 2020 by this �\-kday of Csc"r 2020 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 V- roduced V, f\t-
(Signature of Nota - nom£F� (Signature of Notary lio-State of Florida)
bEANNAMARIE GNENS
Commission No. mycditWi0N#GG 022023 Commission No. Q
H
EXPIRES:December 16,2020
734—:0 , DEANNA MARIE GIVENSSonded TtMu Nota Public Undgwritera •x
11 sg' P
ri GG 0220 3 9
REVIEWS FRONT ZONING�. SUPERVISOR PLANS VEGETATION _ ."Rl&Edad o XC2 i}
COUNTER REVIEW REVIEW REVIEW REVIEW I and e
DATE
RECEIVED
DATE
COMPLETED
T ' I I
ev. 5/6/20