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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 2 `% -d 0 Permit Number: Planning and Development Services SEP 1 c.: 2020 Building Permit Applicatio'�iS'_t'__-'_'LU'cie,,Qounty, iiing Department FL Building and Code Regulation Division Commercial Residentia 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: T"i D-vo'i-' Lo�'l Address: i/gog M146IVD L---19 14V,--A1 M5F , Der" f 1 eRCr , YCL 3!�/ 57'Fa Property Tax ID #: -_ �G'L'L -7-:6 .34yay - 501- 03�l�- coif - 3 Lot No. Site Plan Name: 1`-44 i;D97AA-25 Block No. '71 Project Name: /10,464 12-/'/O6gL �A4Me .z/V 04i2Po2T� eo eVyz'2 i 3 W N bows -I-n on 5 - .�- 52Aln 129 12e5�i D5'6 � New Electrical Meter Second Electrical Meter C{NSTRl1CT�EN INFO# ��� &� .j,-ar.--.. e R'.ATI�� � 9WP <,�„ L - <<•E. 34).w S �f u:,� BB � Additional work to be performed under this permit- check all that apply: _Mechanical _ Gas Tank —Gas Piping _ Electric _ Plumbing _ Sprinklers Total Sq. Ft of Construction: Cost of Construction: $ / 0, 0-0 U - 12 0 ✓Shutters V Windows/Doors _ Pond Generator _ Roof Pitch Sq. Ft. of First Floor: Utilities: —Sewer —Septic Building Height: OWN LE S ... �a „ ..- .>a,. .;4' Erro �"u°.'. .i )° Y° m .S. ,., . 4 w'.<c, x ..-<. f�Y;4 ..:�.✓N l §r . -�" Name �DA/A%#,fA1 YEWM Name: Address: J-Hdg lq,4iI/06s r 1 vie-,, U9 Company: Address: City: rD pie2Gg State: 1�L Zip Code:.499,P Fax: Phone No. -77d ' 4/,k- h9d Jf City: State: Zip Code: Fax: Phone No E-Mail E-Mail:_jvr7e�,7��ie,yr,F✓�a �rce'$'C� Ry�eci�� CpN�j Fill in fee simple Title Holder on next page ( if different from the Owner listed above) State or County License IT Value oT construction is /buu or more, a KELUKUED Notice of Commencement is required. If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. u EJt�P #UlE T L C}�ISTJ � ltJN L EN LAIN tt t✓t R(1AX TaQN:�� DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: LI/Not Applicable Name: _ Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLEHOLDER: /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. Signatu o wner Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF Sw?,n to (or affirmed) and subscribed before me of Ph sical Presence or Online Notarization this day of , 2020 by Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization this day of 2020 by Name of person making state nt. Name of person making statement. Personally Known c/11 OR Produced Identification Personally Known OR Produced Identification Type of Identific i n Produced ) Type of Identification Produced Gf� (Signature of Not r Public- State of Flori ) (Signature of Notary Public- State of Florida ) Commission No. ; <PaYP¢,; AUDREYB(���PPUn�yn HR OMMISSI�QRI G Commission No. (Seal) EXPIRES: March 6, 20237I „oFF;,.•• Bo a ru REVIEWS ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 5 6 20