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HomeMy WebLinkAboutLAAKKONEN PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETE© FOR APPLICATION TO BE ACCEPTED Date: 'T Permit Number: N -0 U AO OIPA-W`�'--`" Building Permit Application Planning and Development Services Building and Code Regulation Division Commercial Residential � 2300 Virginia Avenue, Fart Pierce Ft .34982 Phone: (772) 462-1553 Fax: (772) 462-1578 1 PERMIT APPLICATION FOR. d PROPOSE#" IM4PROV"EI ENT LOCATION _ � r ,. Address: * � *� � l -q-ga� y^'} # f n _ � i�L t� � �3 L' �v1_ Property Tax 11 0 Lot No. Site Plan Name: Slack No. Project. Name: F-D-TAiLEi DESCRIPTION OF WORK: i . New Electrical Meter Second Electrical Meter-, (Affidavit required) F6NSTRUCG` ION INFORMATION' ATION; ' Additional work to be performed under this permit — cheek all that apply: —Mechanical Gas Tank _, Gas Piping Shiners _ Windows/Doors ` Pond �- Electric i Plumbing — Sprinklers Generator Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cast of Construction: $ ­'i 3, ' 0 utilities: —Sewer — Septic Building Height: i_...w.. - OCONTRAC `OR: �OWNER/LESSEE: Name Im tO .r + * s L i 'L'21 0 k i r J E— ame J F Address: I `".'''s c 4:' F Company: City. Port &r(. , , .. State: L Address: ` Zip Code: `� ` > Fax. I City: 5iateJ ! - Phone No, !Zip Code F _ Fax:` a , !� �tail; 4 E^aV �.,�i" ..�5 r �. i i �. +r`',.�,..3�"i. . �:..,� �.^,�y ��� 4 �� i..«s,�.�'e ; fill in flee simple Title Holder on next page (if different E-Mail E frDlti 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: Nam AAA. State: Zip':;:3t!Lol Phone c,4_6! .- gal ._t^,r i FEE SIMPLE TITLE HOLDER: Not Applicable : Name, Address* City Zip: Phone: MORTGAGE COMPANY. Not Applicable 'Address: City: —State: Zip: Phone - BONDING COMPANY: Not Applicable Name., Address: City: 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 obtain financing, consult with lender or an attorney before commmenc . _!!Ig_work or recording your Notice of Commencement. Signature of bw essee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY OF i Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization this ZZ day of _MJA,t8' 20 _Z1 by Aj Name of person making statement. Personally Known _ OR Produ d Identification _Lef' Type of Identification ProducedL_bL___ Of Notary Public- State Commission No. -D - 2a _J� (Seal) t. REVIEWS FRONT ZONING I SUPERVISOR COUNTER REVIEW REVIEW DATE RECEIVED DATE COMPLETED NOTARY PUBLIC STATE OF FLORIDA COMM#GG2,59194 Expires 9/17/2022 __T PLANS t�ON ' SEA TURTLE MANGROVE REVIEW VEGETATION REVIEWJ ' %1I REVIEW REVIEW