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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLE' J', ':OR APPLICATION TO BE ACCEPTED _. �{ Date.(7`� \ : .Z ' a=S ' Permit Number: � 0 Z orryo Mr D Is 0 °` �` °°`' 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: S f n C pRn?�SFn IMOke'), MENT;LO'CATI:®-N. - Address PropertyTax ID#:�7(73—UI2Q-(2od-5 Lot No. Site Plan Name: e (% ,h 9-i! i -ae- � Block No. —l— Project Name: 4 a" ,L c, & %3� DETAILSD DES'CRIPTIONI OF WORK New Electrical Meter z Second Electrical Meter, CONSTRU.CTLON IN;FQWATIQN Additional work to be performed under this permit- check all that apply: erAechanical _ Gas Tank _ Gas Piping —Shutters _AC:'1Nindows/Doors _ Pond JrfI'ectric Plumbing _ Sprinklers _ Generator Roof Pitch Total Sq. Ft of Construction: L`i!a 159. • Ff-, Sq. Ft. of First Floor: vg r fi Cost of Construction: $ 1*70, ! Utilities: Y Sewer _Septic Building Height: 3 a f OWNER/;LESSEE C©N°TRACTOR+: Name a- eta- e ` Z Name: M AT N Vho,44 cl 4cv Address: I'1U tea% 6-f2eq� C;O , 10� Company: & 5-A L ;ce- 2 .t4-V City:®, Lin��[t State: fL• Zip Code: i7�llt Fax: Phone No.'I��Wlk Address: 2 az- City: Et�! �,4��.`e- State: �. Zip Code: 3cl f3 � Fax: �IA Phone No `7'72- 62.e-3%7,4 E-Mail: (VA Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail IDS/ % X-a rm L , /_air7 State or County License � GI ��� if value of construction is 2500 or more, a RECORDED Notice of Commencement is requirea. If value of HAVC is $7,500 or more, a,RECORDED Notice of Commencement is required. IJPPLfEMENTYALNSTRFUCTI'ONILIEN' LAW' INFO'RMA;TION r'...--,_ .. _._ >•. :_-. .... K. __ �.,.. .,! .-,�,.,...:�� ... _.....�... .,:... ... .t. .t.'. `. �.u-4.'_...r-:._^..... a `�^. _ _ _ __ .. _ neI DESIGNER/ENGINEER: _ Not!Applicable MORTGAGE COMPANY: Not Applicable Name: T/I G k t n a ' Name: Address: , C4 Address: City: F&W Vkrz-� State: City: State: Zip: 7tgq,92, Phone 172-S-Zl - 4N(l 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 inaicatea. 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 hrestrict or prohibit such structure. Please consult with your Home Owners Association and review your deed for any restrictions wich 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 poste� on the job'site before the first inspection. If u intend to obtain financing, consult ., rl. nr rorn rriinr vvfYfr nin Ir[m of i�nm19PnrPm Pnt_ VVllll ✓'fib _ _ �•�/ . r G i_ _ �.,.. ^-''� - Sign repfNOwne Lessee/ ontractor as Agent for Owner Signat e of ontractor/ ' ense Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF -,-)T - "LI -P COUNTY OF--,57r Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of X' Physical Presence or Online Notarization V Physical Presence or Online Notarization this Nay of Pe jn , 2021 by this2arNayof P e b 12020 by Irlr� IL- 4 r"c� ]h ]TO ionar IL m ufl ih i TO 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 Produced in nf Produced (Signa re of Notary u li - t oi�inidagowe� (Signature —of Notary Pu icy ofR0 in`L�. weteotFlorida My Commission GG 298212 ` P Expires 02/04/2023 Commission No.GG Ex Commission 23 298212 Commission Now ` ®► Expires 023 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 5/ b/ 2u