HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
.Date: Permit Number:
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Building Permit Application
Planning and Development services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Address: L4us sriHMKUGK KD FORT PIERCE, FL 34950
Property Tax 2421-601-0015-000-2
Site Plan Name:
Project Name: TORRES
r �ri�� i� vvuvuvvva aict-rVK-Sift VVI I H IMPAGI
New Electrical Meter Second Electrical Meter
Lot No. Z
Block No. 2
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: $ 11952 Utilities: —Sewer _ Septic Building Height:
OW
N E R/LESSEE::
CONTRACTOR: .
Name JASEN TORRES' POUT
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Name: Roberto Sanchez
Address: 2403 SHAMROCK RD
Company: The Home Depot
City: FORT PIERCE State.
:
Zip Code: 34950 Fax:
Phone No. (772)261-1212
Address: 2455 Paces Ferry Rd
City: Atlanta State: GA
Zip Code: 33039 Fax:
Phone No 754-224-2010
E-Mail: service_connect_7722611212@proreferral.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail robertosanchezthd@expeditepermit.com
State or County License CGC1522717
,,,,,.� a ,.�n„L„ uuce m �ommencemenc is requirea.
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 doherebyagree 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 000rr, an attorneybefore commencingwork or recordin our Notice
/of�Commencement,
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder ��
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STATE OF FL RIDA
STATE OF FLORIDA m'
COUNTY OF 6f�4 a
COUNTY OF
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Sworn to (or affirmed) and subscribed before
Sworyi to (or affirmed) and subscribed before meMfggOgqg 0) Z
Physical Presence or Online Notari
Physical Presence or Online Notariz$Ro D O
this � day of�ui '�.\ 20�0 by UN i
this day of ��v , 202P by �° X _
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Personally Known / OR Produced Identifi tMrg
Personally Known OR Produced Identification
Type of Identification N p
Type of Identification
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Produced
(Signature of Notary Public- State of Florida)
(Signature of Notary Public- State of Florida )
Commission No. ro:"r J 9 (Seal)
Commission No. g� (Seal)
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ZONING
SUPERVISOR
PLANS
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MANGROVE
COUNTER
REVIEW
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DATE
RECEIVED
DATE
COMPLETE D
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