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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION `TO BE ACCEPTED (� Date: -l-' 30' aDaD Permit Number: ao��� 9M� LOME C61 fj) L, CIEa-, o I l� .. "I'l`"kzlec Building Permit Application Planning and Development Services / Building and Code Regulation Division Commercial Residential V/ 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1579 PERMIT APPLICATION O. 19 D (@ D L`1o'" ��r Dl.p�^� ,s:.�✓'�J�I'A-�ni +'Z 4 tr j F L 4r�i, n,.,y' - x * •"�. _„ Address: Property Tax ID #: 30 l • la l 1, O 1 (a---?- .000.4 Lot No. Site Plan Name: L A,CC�f1-L,0('0CA PCQ on Block No.I Project Name: WJ H F:-L L,LCj New Electrical Meter V Second Electrical Meter Additional work to be performed under this permit - check all th t apply: _Mechanical _ Gas Tank _ Gas Piping all _ Wind ws/Doors _,Pond �ZElectric JIumbing _ Sprinklers _ Generator V Roof Pitch Total Sq. Ft of Construction: o(� `'� Sq. Ft. of First Floo : I LD S O Cost of Construction: $ { �J f S-00 Utilities: _ Sewer Septic Building Height: �• �jr-vim- '�_ r'�"`'e��3 "_'�,.. � n if4lC's:'7ii�'"'z �'..__,-..�� eF+ 7 h. 5,^Y•.�� G +" 1 rk-' i' jPy�Rry`i t" r II]}$$ o a � � i� e � r Y• �— � r .., ,, •h{i WS �, ]° 'I Name . FL LUC" Name: • . •. _ Company: _ i ► Fill in fee simple Title - Holder..• from the • ... • • i .ri i ��lL / �ii yl �_yX 1�.1 rc r • • r I • . r 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. SUPPLEMENTAL CONSTRUCTION LIEN LAW: INFORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable Name:K01 3 lCV _ Name: Address: O© )C. PVT-,-' Address: City: -A V3 . State: VA City: State: Zip: l OG ;J _Phone Zip: Pho e: FEE SIMPLE T 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 len or n attorney before commencing work or recording your Notice of Commencement. el- Z-'A� Signs ure of Owner/ Less ontractor as Agent for Owner Si ure actor/License Holder STATE OF FLOWA ST F INDIANA COUNTY OF b reai0 r'i91 COUNTY OF HAMILTON Swo to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of Phys'�cal Presence r Online Notarization this a day of 20 by P�hhy��..i,cal Presence or OnlineNotarization this O"d>3y of . m 2020 by Name of person makin statement. Name of person ma ' g statement/ Personally Known OR Produced Identification Personally Known V OR Produced Identification Type of Identification Type of Identification Produced Produced 17 VvIN � ,��liiJ (Signature of Notary Public- State of F r' _ (Si ature of Notary Public- State of Indiana ) of prpw Yvonne,M. Senesac Commission No. 1 Py'. Commission No. 0664315 <� •? Hamilton county, IN 00 CIO I � • ' my CWw"Mm HH omo •; NO-' :•`•. My Commission Expires E>fwOrobr=4 °+ S '�r' Februa 19 2023 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 5/6/20