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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 3 20 7-1 Permit Number: L`I a LU CUE ` 4 ' ` � 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: PROPOSED IMPROVEMENT LOCATION: Address: ✓ av/- ..* if ly T Property Tax ID#: 1/ 6 7— .3 Lot No. Site Plan Name: Zr._5A.Ji'1q0e Block No. Project Name: AC 6&v ►t sLa re W1 usaJ r DETAILED DESCRIPTION OF WORK: w New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: Additional work to be performed under this permit—check all that apply: _Mechanical _Gas Tank —Gas Piping _Shutters V Windows/Doors _ Ford Electric _Plumbing _Sprinklers —Generator _Roof Pitch Total Sq. Ft of Construction: ^ Sq. Ft. of First Floor: Cost of Construction: $ r oS� ,©� Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name , !Ji Name: 0,&r1C5 CIW ACSS' Address: GvA 1 d4l&aal Company:AA5i' G[J.%VLGflS'GU+� .� City: G� State:ACI_ Address: .36� �r45 CT 4240C Zip Code: 3999a Fax: 1,4 City: .✓)er l edc-4 State: G Phone No. 970 -3.30— Y '944 zip Code: .13-I/DY -_ Fax:, /_1?_J/__402 E-Mail: !LT2?,5Q z O . co.* ! Phone No-6/^ey1-1,_ 79 Fill in fee simple Title Holder on next page(if different E-Mail/",6> 6tliNGyldJs .Gd/`7 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. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable 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 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 obt in financing, consult with lender or an attorney before commencing work or recor ,ur Notice 4c(tamkencement. Signat ree off O ' er/Lessee/Contractor as Agent for Owner Signa f-Contractor/License old r ��� ) STATE OF FLORIDA STATE OF FLORIDA(� COUNTY OF p� �� �C�I�C t{ COUNTY OF I C��rn QCC�C�1 Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of k Physical Presence or Online Notarization Physical Presence or Online Notarization this L day of fl1 CTl 202 6y this IL day of In ,CC k i 2a2,' by C. Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known Y OR Produced Identification Type of Identification Type of Identification Produced (-r-\ 17 L Produced ]t 01n4� e�0 t`*I (Signature of Notary Public-State J2� ignature of Notary Public-State `, �i JODEAN HISL I`4 r t� (� ODI✓AN HIBL K*t Commission No. 1`1Ja61 9 ES,SSS10N#H9 mmission No. �irs3�o i fEX 00 IRES:September 19,2 ( � OhlivIISSION#AIf36 8 � d EXPIRES:September 19,2 2 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 5/6/20