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HomeMy WebLinkAboutCCF_20201119_084150All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �� Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial y Residential 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: PROPOSED IMPROVEMENT LOCATION: Address: a Property Tax ID #: LA. ` \ �\ ` 000 \ — ©d0 — ` Site Plan Name: R _ Project Name: [\I t Cc Po \V DETAILED DESCRIPTION OF WORK: Lot No.— Block o._Block No. ew _ rco u is v �� Yau u U YJ l 1.Ns1�411 dew H -c s Stem W v( �'Wov �, uSit�-�� ►vow ��e�V;e fie �Ywy\ u c:)w s r ewr New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: Additional work to be performed under this permit — check all that apply: j,LMechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond Electric \1 Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: \_ Sq. Ft. of First Floor: — OP Cost of Construction: $ J r)0,00 . Utilities: —Sewer _Septic Building Height: OWNER%LESSEE: CONTRACTOR: Name )L\C�`� c'i LAN Name: 2 ivk eN e tiJGYOU )JC Address: S� �')c� 2 tJ P Company: 11C��o Address: % �OL,�ZM ` City: P,!s L • State: 1—:1. Zip Code: 31-\ C\ Fax: City: 7::�un� 04— State: -n Phone No. ) �� Zip Code: ��Lk'J� Fax: �J�D�—��$' `0�✓� Phone No -fsa Co�1 6-11? E -Mail CkMCO J—e jQ C -N 10iJ Q 102 tISOy .Ne� E -Mail: +✓ c� U� PS�XOM Fill in fee simple Tit a Holder on next page ( if different 0 L�LA from the Owner listed above) State or County Licensec6c 51 If value of construction is 2500 or more, a RELOKUW Notice of commencement is requires. 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: Name: Address: City: State: Zip: Phone Address: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: Zip: Phone: City: 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 ..ii+h icnAi r nr nn n+tnrncv hPfnr,- rnmmanrinor wnrk or recording vourAotice of Commencement. VV 111 IG114 a.1 VI 411 uaa VI 11� ✓�. v.� ��.. ... .. �..�... __�... _- -_--- _-- Signature of Owner/ Lesse Contract Vas Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF ` COUNTY OF Z4, /I Swo to (or affirmed) and subscribed before me of r affirmed) and subscribed before me of SXPhovs(ioal Ph sical Pres nce or Online Notarization Pres a or Online Notarization day 2020 by this day of 2020 by. this of Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Iden 'fi ati �S Type of Iden 'fi 'at' Prod u Produc meta Minah AF2Y PUBLIC (Signature of Notary Public-X14� (Signature of Notar Public- ate of FI L ( g Y � STATE OF FL T�E OF FLOHI©A No. !�ea !'/'VCE , / r Comm# GG10Commission Commission No. `1 ysINCE # GG105Q4� 19� Expires 5/161 Expires 5/16/2021 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 5/6/20