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HomeMy WebLinkAboutBuilding Permit Application 4'Ah APPLICABLE INf O MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: V Z/ 2� Permit Number: In(D- 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: P �� I �� HBO r1 �n�n S c L 37 Property Tax ID#: !7 l - 6'd- 00QDl 000i - a Lot No. Site Plan Name: !1��Gn�`c U �niCln C lu1, Block No. Project Name: DETAILED DESCRIPTION OFSWORK New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION 4, Additional work to be performed under this permit-check all that apply: _Mechanical —Gas Tank —Gas Piping —Shutters X Windows/Doors _ Pond —Electric —Plumbing —Sprinklers —Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ YQ,UUD. Utilities: Sewer Septic Building Height: OWNER%LESSEEt ; t CONTRACTOR J sy z. .. t�. .. � Name ,( t.5� Name: tTAn K,t 6a" :� Address:5DI 4 I-t M Company:,Ql_)nv', +- '3-t�I tmcf �y-z IU�•a�l City: �(J�G611�S�n _0tV'14 State: l_L Address: lCOl -;CO A-L �S(_ Zip Code:3q q �q pFax: City:�r9r-1 � Luc;" State:-EL Phone No. ',I Zip 1 -aq�� Zip Code: 3qq 53 Fax: E-Mail: Phone No 7_1a - 639 - qY0 IL Fill in fee simple Title Holder on next page (if different E-Mail Fr-Lhh. Q_ (p l 150 Q QMQ"'I from the Owner listed above) State or County License cl3 i 9 0b q 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. a:il;0 SUPPLEMENTAL C«ONSTRt1CT10N LIEN LAW INFt�RMATI© DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Sou,+h at4- Name: Address: S ollr Address: City: ace. Stater City: State: Zip:�5252.1 Phone :77Z-- 7-7 -- 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 y intend to obtain financing, consult with le er an attorneybefore commencingwork or recor ' Notice of Commencement. Signature of ner/Lessee/Contractor as Agent for Owner Signatu of Contractor Icense Holder STATE OF FLORIDA(�.� I L�n j� a �l ` 1, STATE OF FLORIDA f� �j COUNTY OF COUNTY OF 1 1 S or o(or affirmed)and subscribed before me of Swor o(or affirmed)and subscribed before me of V. ysical Pres c r Online Notarization sical Pres r Online Notarization this day of 202t by this day of 202t by r it Name of person making statement. Name of person making st�at ment. Personally Known �OR Produced Identification Personally Known ! OR Produced Identification Type of Identificati Type of Identification Produc d Produced (Signature of Notary Public-State of orl a ) (Signature of Notary Pu lic-State of Florida Commission No. sRr'u Notary yp fate of I{oflda yR�P� Notary Pu¢pc Stele of Ibrids Melissa we Commission No. Melissa ea a My Commission GG 115639 c My Commission GG 115639 a`O 06/2021 Expires 10106/2021 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 5/6/20