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HomeMy WebLinkAboutBuilding Permit Application I All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: V"��' Permit Number:pl© I ®® 5 V'`.l(uJ cm RECEIVED O Q o ID".1 =: � NO 0 2 1010 Building Permit Application Permitting Department Planning and Development Services St. Lucie County 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: PRPOSED`IMFRO�/EMiENT,LOCATION = a t` 4 f Address: Property Tax ID#:_p27J-J1 ag, 102 coot oco =d Lot No. Site Plan Name: Block No. I Project Name: CTt - 7 Y l rl\ b a r'ri e C. ( 1 New Electrical Meter Second Electrical Meter i t , t 7 t ' ;' tr+S{•N7 L'V, .. tt t °CONSTRUCTION hN�FORMATION , '�+r t t t ' „ r L'tt� "f' " - i I 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 l� f Total Sq. Ft of Construction: L.1�I� Sq. Ft. of First Floor: - Cost of Construction:$ c1O Utilities: —Sewer _Septic Building Height: OWNER/LESS,EE'': a a CONTRAtCTQR z t 'Name C)G),it 5., Name: Add dti� a Ra IS RAI (L Company: Git F r Y. � .: e cc e_ State:q-' Address: s.:..:.:......:.: Zip.:Codet\ Fax: City: State: Phone No. <�C)qv� Zip Code::_.•_.::. Fax: E-Mail ut S r.,\ Phone No Fill in fee simple Title Holder on next p e (if different E-Mail from the Owner listed above) State or County License i i 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. i � i t r-- -+-+-t•- •f�.>. ,..,-+�ylt{r SUPPLEMENTAL CONSTRUCTIONN}L'IEIV LAUVtINFORM/�Tlr� N 3 Y DESIGNER ENGINEER: _Not Applicable MORTGAGE COMPANY: ` Not Applicable Name: MQkc',34-,}S s:k5�,c\ OC.>L�,raS Name. Nry,*.i-4��S,&__ Address: '6\Aa0 (1�u Address. ' e_ Q. City: P,Q Cc.R State._ city:-f�-\,0,),g � C'1 c� State: Phone-)-& Zip:gXJ\,,Q. Phone: Oqt O 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 n�rep-esentation-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 proiii6it 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 Lwill;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 lender or an attorney before commencing work or recording our Notice of Commencement. Gu .A" 4hC Signature of Owner e/Co racta s Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA . STATE OF FLORIDA COUNTY OF «"ve r COUNTY OF t axc� "Cr Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed) and subscribed before me of Phy��ss'caI Presen a or Online Notarization Physical Presence o1 r Online Notarization thisQjr'day of dc� r 12020 by th'sa&6clay of C)A-c�•cf 2020 by \Nay V_1A"\iZ::i vs Name of person making statement. Name of person making statement. Personally Known e/ OR Produced Identification` Personally Known , -- OR Produced Identification Type of Identification Type of Identification Produced Produced -\�-\Ct 3,M_ Lu'l Lu��C�,L L (Sign ture f Notary Public-State of Florida ) (Signs ure of Notary Public-Stat 1 r 6� MARY L.WACKER E-90W46-- � r NARY L.WACKER ��I ary Public-state of to a a l/ ® . .• Commission No. 4 C]U .8:. Se Commission No. , a Commission#HH 001 7 N tary ublic State of Florida '•'.� o� M Comm.Expires Jun 6 2 4 Commission#HH 001877 of A,. Y P sn.3orcec throug National Notary Ass .REVIEWS FRONTPLANS VEGETATION SEATURTLE, MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Ve-v-. 5/6/20