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HomeMy WebLinkAboutBuilding Permit ApplicationI 4 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: l n` �Zlc> Permit Number: ,,70/0 r G 1�lr NO, ° Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: ,PR®POSED:.TMPROVEIVI?ENT.LOCATLON..., Address: (0 -V�1 Lam( �_- /WK 1 U 4s1 V u t-L_ 2 Property Tax ID #: �� l - Lot No. J Site Plan Name: Block No. Project Name: ���( / n'G�� t� kp!:� D;ETAIL'ED DESCRIPTION OF WORK: ... ,. .. ran k- c ©nVV I-GC1VVAr Q -i�o 0241'L 0 lCil ncrV �PCAU iLP rra f-e- G Q/ r (.�c� . a l WI/)CIDw New Electrical Meter Second Electrical Meter GONSTRUCTtION';INFORMAlION r 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: Cost of Construction: $ (O rDE)O Sq. Ft. of First Floor: Utilities: —Sewer —Septic Building Height: ix` 4.. ... .. ,-r� OWNER/LESSE'E": ter_ ONTRA(ITOR. Name wzda Name: Address: C.� Wi Company: City: r(- p ( Q IaT_ State: �% Zip Code: L �1 F�ax: Phone No. 2rr l 15 2 Z tj � Address: City: State: Zip Code: Fax: Phone No E-Mail• Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail State or County License If value of construction is 2500 or more, a RECORUEU Notice oT (.ommencemem : is requireu. If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. _, F+.,..RUCTION�I N LAWIN:;®RNJATI;O,N, SLIPPLEIV�EIIA CNST E i£' 'Y+ a, DESIGNER ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable Name:' <WC, Name: CO Address: CO Address: It 'Z I1 Oz City: -71zSI State: (, City: State L, Zip: Z Phone ZI`9-1 9 Zip: Phone:77-7 101 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 postedon the jobsite before the first inspection. If you intend to obtain financing, consult ,tAth le der or an a ornev before co encine work or recordiniz vour Notice of Commencement. Q'i Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA , STATE OF FLORIDA COUNTY OF COUNTY OF Swor o (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization Physical Presence or Online Notarization this day of �G�� 2020 by this day of 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 roduced 41ye ram. (Sig ature of Notary Public- St of Florida a � �nunv Signature of Notary Public- State of Florida ) Commission No. (Seal) �3 ommission No. (Seal) mo3° 6 REVIEWS FRONT ZONING SUP F?4%� LANS tEVIEW VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW R 10';k REVIEW REVIEW REVIEW DATE o X d RECEIVED N'2. w� DATE a COMPLETED ev.