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HomeMy WebLinkAboutBuilding Permit ApplicationJ All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 2l 20 LI Permit Number: !;, LLI..L LL RECEIVED Building Permit Application U� JU Ni Planning and Development Services Building. and Code Regulation Division Commercial Residentialst.luole Ppriliffli inty 2300 Virginia Avenue, Fort Pierce FL 34982 R�`E7VE0 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: k v I't-lt $ (✓l fah. - - `ucl %LDS£ St. Luci it lwN. Y :..Ra�uIr.�T t �. : : "�: Address: :2 2S Al IM-V 41 A . zor o -j 4MV19 /S,LAWb R& , / ;e&/NV j/ -46W; Property Tax ID #: .T (j 3 _GG 2 ?- Lot No.-7-17 Site Plan Name1&UA)h,96hJh R&4T1,6A1 00 Ole Block No. Project Name: ©Gt N.b I-5LhA 1t1r;;& $r&# go-"/ (/�.A :`•+'. i-y.t�.� .• `�.' . :: ...1'i :j,:: r....:.rl;.] [q[,'v.'l� �rr]e•..� y.Y--{�, ... vr[ .1" - l'.,/Y rr •�C• .�t1��•:�1;:: r'. �:f>i: •: :-y _i- Yz�; .li :�:: V.�'nYil M.•1� nl .0++._#IOIf_R1PQItIOlh(Rpy: ;,.:•,_ -..,r:rr�.•s•FY -7•. .vvs _+_i.r.p� ,:,• ::9...:. ....r. CAPV% S �KfiGi'�.t)N &A - j-' ,c L-P S t tic�lL L 1iw- ,% i iL4 S on&,--L New Electrical Meter Second Electrical Meter Q : ST .; iGTtON N :OR . g y[�:•s Additional work to be performed under this permit- check all that apply: _Mechanical _, Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond _ Electric — Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: _ Cost of Construction: $ Utilities: —Sewer _Septic Building Height: .f. a=i:. •SSE.: -��. _ -:.:l�v,�: �`y.Y yil'i •->•r.;:%S'::rr•};] Y. FY. •'.t'i•: 4. �_�.�ONVR'AC!'ORr::::• {---,:. ..�..,;j-• Name 91541 A599QALE5_ Name: 4rA K C=g, Address: 170d 6/a'12 AW, Cff Company: Coo k Cv^tUACIC� LL City: PD State: Address: 7 $v 3 SV Irk (/St w?t/ �w Zip Code: 333/3 Fax: City: s(WTdl►ir r State:t::�L Phone No. SY- g/ Zip Code: Fax: E-Mail: 4-117#1 . Phone No % 7 2 - 2 Y 7 - 71570 Fill in fee simple Title Holder on next page ( if different E-Mail u IC K & Q- 5Cnk fk-14 COW from the Owner listed above) State or County License 65a A L 191 If value of construction Is 2500 or more, a RECORDED Notice of commencement is regwrea. If value of HAVC is $7,500 or more, a• RECORDED Notice of Commencement is required. nw••-•:.'+a. xgd9.• .: :• -v '• S i'' 1 ff�� �•'Y!"Y7 a•t... a - :r. •; �.y..�, ;- 1 ��,o. •d kid':. DESIGNER ENGINEER: _ Not Applicable MORTGAGE COMPA Y: r, 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 re�tnct 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 Countv and nosted on the iobsite before the first inspection. if you Intend to obtain financing, consult or Signature of Owner/ Lessee/Contractor as Agent for owner STATE OF FLORIDA COUNTY OF or OT STATE OF FLORIDA COUNTY OF MCLr' In Sworn to (or affirmed) and subscribed before me of Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization _,%:� Physical Presence or Online Notarization this _ day of . 2o20 by this,l,•• day of 2020 by Fr'ol.nk C�ol� 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 Produced �v r w (Signature of Notary Public- State of Florida) (Signature of N ma—w ROWN 32339iCommission No. (Seal) Commission No. 812 REVIEWS I CFRONT ZONING PLANSOUNTER I REVIEW I SUPERVISOR REVIEW I REVIEW I V REVIEW N I S REVEW� I MREVIEWVE