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HomeMy WebLinkAboutPermit App & Drawing All APPLICABLE IN FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED DatePrmi• F t0% r� r � • Rr ces B ilding Permit Application Planning and Development Servi# Bul"'Iding and bode psident 'lal 2300 Virginia PERMIT APPLICATION FOR , (!TP%%N I C \ one : ( 772 ) 462= 1553 Fax ; ( 772 ) 462 - 1578 --- ---------- PROPOSED' IMPROVEMENT LOCATION , ---------- - -------- -- AFW 7> A ress , 111111 ax �c � . Lot No . Project Name : WORK & S *ite Plan Names, Block No . J NMI rA A-L CLf, � y New ■ ElectricalMeter ' ti-r ..Cy }':' ai •r_.fir. :?:4-i:�:'r:'{tiv' •},+�{ r, t-. ,,.,f, +� +'��ti }'}:_ ��y, �" "�.-.,�L�' :•_i:'+ •2"{�Co-'�p•. ice•. C:{,n :'.��G �, ,2i1". :+{'.ti' •,�r�_ ry�r�• ;.¢ �r.:r:r '•ti:: .. 'fdr,1.7"f! .'�. r .....�-rl,"-3�0:-00>•'• +{.{yr'�" .,`.'�1 '?��'�'• ' :{�Y���c•}7•��?�r '� �. .. ..r '.4�. 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Name Name : Ad d ress i a Co m a n" {' 1 0 i ty * } State A dress , # Zip Code : F a xState : City * - - i a L Phone N o . dow, 4PW Zip Code : Fax@ dFI - 41 E - M f Fill in ee simple T Holder - Mai I I 1111dill I- from f Owner listedte or Coun V icense If value of construction is 2500 or more, If value of HAVC is $ 7, 500 or more, a RECORDED Noticef Commencement is requ dpit ,:' SUPPLEMENTAL CONSTRUCTION LIEN LAW . INFORMATION : DESIGNER/ ENGINEER : _ Not Applicable MORTGAGE COMPANY : Not Applicable Name : Name : Address : Address : City : State : city .* State : Zip : Phone Z i p : Phone ,• FEE SIMPLE TITLE HOLDER : _ Not Applicable BONDING COMPANY : Not Applicable Name : Name : Address ., Address : C '1' t y Ci t y : Zip : Phone : Zip . Phone : OWNER/ CONTRACTOR AFFIDVITes Application is hereby made to obtain a permit to do the work and installation as indicated . certify that no work orinstallation has commenced prior to the issuance of a permi t. 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 a ppl i cable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structure . Please consult with your Nome 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, 4P accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use WARNING TO OW NER : Your failure to Record a Not ice of Commencement may result in paying tw ice for improvements to your property . A Notice of Commencement must be recorded in the pUblic records of St . Lucie Count y and posted on the jobs ite before the first inspection . If you intend to obtain financing,, consult with lender or an attorne before commencingwork or recordin 9YOur Notice of Commencement . Signature ofl��wner/ Lessee/Contractor as Agent for Owner SignatWe of Contractor/License Holder STATE OF FLORIDA � STATE OF FLORIDA , COUNTY OF COUNTY OF_ Swor o { or affirmed ) and subscribed before me of Swoll o or affirmed and subscrlp ibed before me of MWEEMEW hmmw� Physical Presence or Online Notarization Physical Presence or Online Notarization t h 0 is i �� day of , 2021 by this 11:1 day of `4vVZ 2026 by Name of person making st ement , Name of person making st ement, Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced AM 0 — dr MF ( Signature Notary Public- State F ure of Notary Public- S dP e ncy NotaryPublic State of F orida public state of Florida Commission No . i° �e � )Mar aret E Monte a e o�*x�` � �, Nota ry montepare 9 P Com ssion Np. � : M ���� 214990 y : � My Commiasion GG 21950MYion GG y'* � a� Expires M/05/2022 `�� � - `�-or 0610512022 Of f� REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE M A N G R OVE COU NTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev . 5/ b/ 2 1A VO op k 9 } } d,�,R i 4 J 1: 4 � F + r'� * O F r .� % h * Md t h i Ar- A MF • + f JI 94 i r } r r i �4 7 T l r 1 F ■ aaWl* co 74 r T.� 7 . � � t qww ��. or All dh lk f • 0 00 r ' y- mw P. ,�9 rAl . 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