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HomeMy WebLinkAboutBuilding Permit Application All APPLICABL E INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: L._ (,5'--cPOa I Per it.Number: 55/- OUW BLUEBEAM Building Permit Application Planning and Development Services Building and Code Regulation Division 2300>rrginia Avenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential V PERMIT TYPE: `PROPOSED lMPROUEMENT.i.QCATION Address: tt . -- e Property Tax ID#: 3L(n 5 5C)O 103 Lot No. Site Plan Name: IC� c�1r M ©S UC3iC'0G�\e.C\ Block No. Project Name: t3ETAICED DESCRIPTION Of`WOlZK t CONS7'RUCTiOfV INFORNIATIQN Additional-work to be performed under this permit-check all that apply: Mechanical _Gas Tank w Gas Piping _Shutters Windows/Doors 'Electric _Plumbing _Sprinklers ^Generator Roof Pitch Total Sq. Ft of Construction nn:: . Sq.Ft.of First Floor: i Cost of Construction:$ 3 ) `�19 q,Gy Utilities: —Sewer LSeptic Building Height: OWNEI§AESSEE coNTRncrOft Name l L o'- ame.::: Address-_�O �a 'i...g Company: ►� �Lf� ten,. r� City: Yc� �-y�,;e State: L Address: Zip Code: 3�I at Fax: City 1=T 19 C f-C,-C —State: -P Phone No, 5 L-1 a a 6 (7 c{(<W zip Code:_3Y 9$�:L Fax:71a(66 2317 E-Mail: (rim SQ JOD QD ChMr4 Cdc`� Phone No 1� (o �b3 -- Fill in fee simple Title Holder on next page(if different E-Mail k1 a Y,- t} - -r-n e, OLti from the Owner listed above) State or County License If valueoif construction is 00ai more,a RECORDED If value of HVAC is$7,500 or5mo e,a RECORDED Notice of Commce of encemen is required. red. Commencement is required. I rIII Jill 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: _Nat 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 wilt 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 1 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,walis,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,OBTAIN FINANCING, CONSULT - WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." ` 14 Signature of Owner/Lessee actor as Kient for Owner Signature of Con r/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 0c,I e-, COUNTY OF 5 I l-0 2 C, The fo�r�oing instrume t was acknowledged before me .The forgoing instrum+t was acknowledged before me this-L.5 day of 20L�Lt by this-a day of J on e, ;2021 by Abe r�- �r� l 19 po kier4 Z( n e,, Name of person making.statement. Name of person making statement. rsnnlj�c Knaw?� OR Produced Identification PersoZ11yitification no OR Produced Identification Type of identification Type Produced Produced t (Signature of Notary bli -St of Florld (Signature of Notary Pub c- ate o or Commission No.GC �� �5a (Seal) Commission No.GQ-1 �•�C �� -.00 Ne"ryPubk 4a orFWiea( Kimbedy Lars e ME lms i 94�52 REVIEWS FROM' ZONI scc� � EGETATION SEA TURTLE MANGROVE COUNTER REVI or RLL'IUs MEVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE,- COMPLETED ev.2/771