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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �J Permit Number. RECEIVED Building Permit Application MAR 19 1011 - Planning and Development Services Permitting Daaartment Building and Code Regulation Division St. Lucie courrty 2300 Virginia Avenue, Fort Pierce FL 34982 Phone:(772)462-1553 Fax: (772)462-1S78 Commercial Residential PfRM1TTYPE: �� `i r � � tea_ - - - _ r Address: /;? OyZE.'J Oe ps CT Property Tax ID'#: /4 /y - 7©/ 01Sk -Uoo_ Lot No. Site Plan Name: Block No. Project Name: W- 0 E.—I WIL W M.W- &W 4- 0t,�''' '3 :�,.�-5 s � - z- u s -�s'w 't£. rt-a"�, a��� Additional work to be performed under this permit—check all that apply: _Mechanical _Gas Tank _Gas Piping —Shutters ^Windows/Doors , Electric Plumbing _Sprinklers —Generator Roof; . Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ 00. p Utilities: —Sewer _Septic Building Height: Name Name �u►�� s i��'tr x ='Address Q,S G� I Company . seb State P'_-3 L-J4 A=E C -zi Gode 4; Fax:+ City Fes'. er c-C � State:3_ Phone-Non + , ,i :,� .,�� r' Zip Code "' Gt g Sl„;> Fax: .,, E-Mail: s _- _° ,. Phone No S+C6l-'.ot l i7 Fill in fee simple Title Holder on next page ( if different E-Mail 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 HVAC is$7,500 or more,a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Ndt Applica ble 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.anci installation as indicated. I'certify that no work or installation has commenced prior to the issuance of a perrnit� ' ''' 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-youf'deed fdr-any restrictions whicli,rnay apply. In consideration of the granting of this requested permit, I do hereby agree-that:l,wil{, in all respects,perform-,the work in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendrrien'ts.` 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 YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND POSTED ON THE JOB SITE—BEFORE THE FIRST INSPECTION. IF YOU INTEND TO 013TAIN FINANCING, CONSULT WITH YOUR LENDER QR AN ATTORNEY-BEFORE,RECORDING ;YOUR NOTICE OF COMMENCEMENT.- Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLOOR A STATE OF FLORID COUNTY OF 7 - 1.UC`� COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this%4l day of0.d 2016.1 by this\'\ day of tMgr 20� by v1,1Ch 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 Identific tion Produced L ProducedL'�L (Signat 6re'of,Notary Public State of FI i DpNNA�\V`No :(Signature of Nota Public State of Florida ) r Commission No. pa blictNN096352025 pF � ICIVEuS .o �:. N° ��555oniteslan28' Assn• Commission No. 1 Mate of Florida og' mm,EXP, a\HotafY ;.,. �• Notary Pu�lu My Co Nation _ <e Commission#,Jana2g 52025 °F nde F"_. ou h Nall tonal Notary Assr REVIEWS FRONT SUPERVISOR PLANS VEGETATI S COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW, REVIEW DATE,-, _RECEIVED' ,` \ " DATE ' {. COMPLETED ev.