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HomeMy WebLinkAboutApplicationk rv� �� hl r . 1 C 0 � � ' [ d �' Y� l �l 0h �/ All APPLICABLE INFO MUST BE COMPLETED Date: FOR APPLICATION TO BE ACCEPTED Permit Number l C) ®oLLUUI R Planning and Development Services RECEDED Building Permit ApplicatiaQmen St. Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue, Fort Pierce FL 349g2 Phone: (772) 462-1553 Fax: (772) 4E 2-1578 PERMIT APPLICATION FOR: PROPOSED IMPROVEMENT CATION: Address: 1133 S us- 41 vv&Q LL-Lc i e_ : Property Tax ID Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION OFWORK: 1i► v'Lv� f Y4 13 dA66 c a- �1mg2 a;,^ Cw' It 0 New Electrical Meter Sec�nd Electrical Meter CONSTRUCTION INFORMATION: Additional work to be performed under this permit- check all that apply: Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond _.ZElectric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: %/ 00! Sq. Ft. of First Floor: Cost of Construction: $ Utilities: —Sewer —Septic Building Height: O ;NfR LES CONTRACTOR: Name f `v,►I 13&.y ry-S , Name: Address: `� LL5 • l( City: _� i pie- dle, Zip Coder Fax: -' I Company: TJ INc State: ; L- Address: 2-g� City: State: ,f Phone No. 1 r q. Zip Code: , y)-7 Fax: 1 ( C' page ( if different E-Mail:loi (` kli sl U Fill in fee simple Title Holder on next Phone No E-Mail e, • �j State or County License_�L" from the Owner listed above) 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. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: 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 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 with lender or an attorney before commencing work or recording our Notice of Commencement. Signature o wn essee ontractor as Agent for Owner Signature of Contractor/ icense Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF St L.v C i e COUNTY OF Pal v,,, i3,-a c k Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization Sworn to (or affirmed) and subscribed before me of >' Physical Presence or Online Notarization this day of 2020 by this /6 day of J� 202q by �'C'(ew,vI Pscy,reS -z- Tve�` Name of person making statement. Name of person making statement. Personally Known_ OR Produced Identification Personally Known OR Produced Identification Type of Identification Producedv,r. Notary Public State Amanda N Leca My Commission G Type of Identification _ i 2G r©_�� ^�� of Florida u 981079 i ture of Not Public- State of r' of Notary Public- State of Florida ) Commission No. ra C, c1% I O?q (Seal) Commission No. :111 R�a%JgOLOMON MYCO N # GG 919917 , �o`,: EXPIRES: October 6, 2023 _o ru NOVry � _u n LT - es REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. m IN P 1- I ra I"