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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 1-1 11 C�Permit Number: L - 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: �e _� • PROPOSED IMPROVEMENT LOCATION: Address: �9C)(�� ?ao— C->'{l/��p 'IU�T�iCtle Ft, 3yc Property Tax ID #: I tool -4013 - vary - 000 - o Lot No. 1 Site Plan Name: Project Name: Ay, ) cd.2s 7 Block No. )L DETAILED DESCRIPTION OF WORK: Tau - Oq S h I n . i✓I SSA n� sh►���z (Sv�Z� OL-" �'�ir�r su L 41 - v . 1�.0 CA-rn n� ' h 111 I'00 New Electrical Meter (1 Second Electrical Meter N CONSTRUCTION INFORMATION: Additional work to be performed under this permit- check all that apply: Mechanical _ Gas Tank _ Gas Piping _ Shutters Electric _ Plzjmbing _ Sprinklers Total Sq. Ft of Constructions . • 5�• (_0 Generator Sq. Ft. of First Floor: Cost of Construction:Li Utilities OWNER/LESSEE: Name;Cs�s'bl�d Address:lo°10l -Paci" - Re,rne_ City:iz>rk-9'erce State:TFL, Zip Code:Fax: Phone No.o�-�-� E-Mail:4umu ssios©grYw I • Lc.rn 'Fill inJee simple Title Holder on next page ( itdifferent .from the Owner listed above) , Windows/Doors Pond V/ Roof IoZ Pitch Sewer _ Septic Building Height: )yf CONTRACTOR: Name: c�hr^^ i ��01 (Lc�sstier Company: Riser go�i�'t� Address: _49i Sly-+Fccle� Nw`-� Ste' a�x City: S*X'-.Ck- State: T-- Zip Code: ���1 `f Fax: Phone No E- M a i I Dear m i'i3( wss erYYz� tic �.� State or County License CCC 133l �l J l k. If value of construction is 2500 or more .$ ECORDED Notice of Commencement is required. xt' If value of HAVC is $7,500 or mote, a 915C011DED Notice of Commencement is required. i SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: x�t DESIGNER/ENGINEER: V� Not applicable MORTGAGE COMPANY: Not Applicable - \ar'ne: ,.udreSS. State: City: Zip: Phone FEE SIMPLE TITLE HOLDER: Name: Address: City: Zip: Phone:_ Not Applicable Name: Address: City: State, Zip: Phone: BONDING COMPANY: Not Applicable Name: Address: City: Zip. Phone. OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated, certify that no worn or installation has commenced prior to the issuance of a permit. St_ Lucie Countv'rrakes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in cortlict 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 concurrerlcy review: room additions, accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory usQs 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 w10 lender or an attorney before commencing work ciecording your Notice of Commencement. ature of Owner/ Lessee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF n� e- Swgh n to (or affirmed) and subscribed before me of ,/ Physical Presence or Online Notarization this 10 day of LQbqCXY1 oa ✓ , 2020 by Name of person making statement. Personally Known I/ Type of Identification Produced OR Produced Identification (SofiT�(re f Notyfy Publ Commission No. 14 F) 5B 4- ,,REVIEWS FRONT .CbUNTER DATE `• `:+ RECEIVED DATE COMPLETED ev. Signature of Contractor/License Holder STATE OF FLOJDA COUNTY OF uxC e Swto (or affirmed)'and subscribed before me of orn Physical Presence or ��nline Notarization this I today of L.1s�,kyl ' 14 : , 2020 by Name of person making Statement.. Personally Known Type of Identificatior Produced ✓ OR'Prt1duced Identification I'yP" r 1�LLE MARIE GONZAL Z gna�try� of No Rt�Vic- at�,q,,,, ((// / - NIELLE MARIE GONZ� ��. Notary Public State of Florida ;io`P ���; C gj ssion H HH 58825 t NQublic•Stete of FI My Commission Expires mmisslOn NO.F+If C 4in o; November 01, 2024 MY ssion Ex 4 ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE N A'NG REVIEW 7 REVIEW REVIEW REVIEW REVIEW REVIEW