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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST B& c:;MPLETED FOR APPLICATION TO BE ACC'�'.:'-.-:D v1 I�p Date: PermitNumber: ��o d�IC�DG �r o 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.OP®�SE® hIVIPRO�V�E�M'E�NT L®C�ATI"0''N: Address: Property Tax ID #: �3�(O ' It t —ooc � �0 00/O Lot No. Site Plan Name: Per I Ito Block No. Project Name: f,rL �o Xnshat screen rea vi Dri nctshrL5 s(&-b. New Electrical Meter Second Electrical Meter 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:. 2YNOP Cost of Construction: $ � ✓ i° 0 Sq. Ft. of First Floor: Utilities: —Sewer _Septic Building Height: ©WNER+/LEN-5-13 E: CONTRACTOR: Name Q. Name: Address: Ao 50 JAZ ItrX /nI f A)C Company: City: Al LL ML I State: � /�r1�15 Address: 7'7 t 15-tj e �/� Zip Code: 3 31 Fax: f, City: Po tnp"'o 1 Stater Phone No. Zip Code: 33 60 -Fax: gSCO 'o2-0115 E-Mail: Phone No foo Fill in fee simple Title Holder on next page ( if different E-Mail thawall n p C`' &vn504Qe" cop" from the Owner listed above) State or County License 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 P oo r . -A DESIGNER/ENGINEER: Not Applicable Name: J GLhn t'S 6U,Shou.se. Address: 3300 iU� !0 TeYr State: F( City: po * o � o ��� Zip: 32:z Phone 95cF-halo -o�2 Q3 FEE SIMPLE TITLEHOLDER: Not Applicable Name: Address: L G/ City: Zip: Phone: MORTGAGE COMPANY: _ Not Applicable Name: Address h State. City: Zip: Phone: BONDING COMPANY: Not Applicable Name: Address: FitG--- City: 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 be.permit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restric t or ibit 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 concurrencyreview: 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 ..•;+k nn ntte rno" haf„ra-rnm mPnrina work nr rpr_nrdine your -Notice of Commencement. )gnca—ture Signature of Contractor/Lice se -Hold -of Owner/Lessee/Contractor-as Agent for Owner STATE OF FLORIDA STATE OF FLORID4 COUNTY OF 16�. � "e, i 'e- COUNTY OF 6 r 0W&Iydl Swoyn to (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 a day of - 64* , 2020 by this a.4 day of Q c , 2020 by f rr"CIS pe'r 1 J (-(,t wIrage_f_ V. CIGkrtn.oWlCZ 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 P uce r duced is twate (Signature of N ary P k�,YL" (Signature of tary Pu lir5 r o �' age ion GG 322569 �r of Expires 05/05/2023 Commission No.Commission No. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 5/b/ZO