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HomeMy WebLinkAboutBuilding Permit Application AII.APPLICABLE INFO MUST BE, OMPLETED FOR APPLICATION TO BE ACCEPTED Date: ( a-"�`� Permit Number: V Building Permit Application Planning andevelppment Services Building and Code Regulation Division 2300`Virginia Avenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential PERMIT TYPE: O _n F,'y� Rf � iYf-FIC�X1 '�V�fTI r�r ,- .Address: t'3(0 M Property Tax to#: `3tl9-530'0255 OCYS- Lot No. Site Plan Name: Block No. iih Project Name- TUI and N my"3ti t`t. tfcf�v[x',���'�it-('�rrKa� t,_i/.f� a+k -�.scv' t„1`i^�"[,ye..�y'�^F u.5'tii � i r"�s �'✓-"�* s'�y.:l' 3'� x X��4 �5 by.:���z+ .,.,.uv�,. �s�� 4 s,F,.7 a ya�„r���+,'. �x��,_A.S.�z.ii,�r ;'�'.. ..�:?.:.' s5,^.-�,,,h.Kz�t u25..�._::;a.a. >� x.i�7:..4<tl��£ tx �:'v:��� �_��a.,�.., %..-h�.�_,' }�1�;1���`�,C-�� i�< �ns >�>Et.;tFF'f,� ;,a.,,'s z1'�.°� '2 .x�': • I $' Of f ) le ie - 4�FY�Ti�.�4'�/,I�. ,.,,.a,n:r• a- ,.�.9.,;" ,,...>;:c��, ..�-��,�e .�:�.k ..."-'���ue...���`}'��r.c,r $��.c� ..-1 �, '�s�L ..��,�»���-.l;.�r�� �F''�'x._-.:'x ck,.4-. �l-, �s�-�x'`��t `�''"€�.s,.4%� ''�.�.. `g. . Additional,work to be,perforrrmed under this permit_check all that apply: ..Mechanical _Gas Tank Gas Piping Shutters _Windows/Doors Electric _Plumbing Sprinklers Generator _Roof. Pitch Total Sq.Ft of Construction: Sq. Ft.of First Floor: a Cost of Construction:$ 3�t`�.©� Utilities:. —Sewer _Septic Building Height: w, ({n�j•(�` ({ �i z s �, x c. r' a� �: ,Ryy(� .y[� �. � q � -zf�5 ,,. s.;� -s �. � .a� r: ,'"�,� � �'. N� •Jljj,11+� b "' F fi Y :k S 4 7 Y .Fs �i} 3w'J'„ 4 S Y -y+ �s.k^ ^A. 'r o`. �.i.§��, Name DOUtd 12 Tutian6 Name: Tasl-dria tfVr_ q Address: t3(a W NClrn+ni Ave, Company: Q 6fP9i 'ti Xk .GayoLde fiXW2 . City; pYk RkiA(— L I State: i:_�k Address:q 2a NA(R n 1�T) 51; Zip Code: 3iiUl Fax: City: 1,161 eam State:-FL Phone No.TIS • W7- (oa 55 Zip Code: 13Qlk. . Fax: a2l 31 2- W11 E-Mail: dy-- kk wno @ G)fta 'k .cw,\ Phone No Fill'.in fee simple Title Holder oft next page(If different. E-Mail afd nce from the owner listed above) State or County License 30q$5 . if Value of construction is.$2500 or more;a RECORDED Notice of Commencement is required. If value of HVAC Is$7,500 or more,a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY:. _Not Applicable Narrie: 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 Counttyy 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 forany 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 YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY.;A NOTICE OF COMMENCEMENT MUST BE.RECORDED, AND POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR.LENDF R OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." ignature weer/Lessee/Contractor as Agent Tor Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF durjp COUNTY OF 8(fV6rd The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged,before me this day of ,{�C�GQSi1 Y .20 26 by _ this day of G�'m �' .20 Zb by . � M1 f N a h Name of person making statement, o Name of person making statement. Name o Personally Known OR Produced Identifi t1bn'T Personally Known X1 OR Produced Identifi tign N Type of Identification c N Type of Iden i�r�ition °h Produced.F. n>rlUEi'& ,t,C nc Produced. f+ G E Tie c v- ZNZ-w C `. (Signatur of Notary Public-State of Florida} (Signatur of otary Public.-State of Florida) , Commission No. (Seal) ,`,, Commission No. (Seal �"•�`� REVIEWS FRONT ZONING :..SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE .. COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED :Wv.217119