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HomeMy WebLinkAboutBuilding Permit Application�i All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: Cp Q"'O © - - Building Permit Application Planning and Development Services Building and Code Regulation Division COnln1erCial 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: PROPOSED IMPROVEMENT LOCATION: Address: L — — Property Tax ID #: 7j/�$—�Q Site Plan Name: -. f2 rLln t m-0,A. 5/ Q Project Name: DETAILED DESCRIPTION OF WORK: New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: Residential i/ Lot No. 748 Block No.. Additional work to be performed under this permit— check all that apply: -Mechanical —Gas Tank . —Gas Piping _ Shutters _ _✓Windows/Doors _ Pond \/Electric VPlumbing _Sprinklers _Generator ,Roof Pitch Total Sq. Ft of Construction: ,77-0 Sq. Ft. of First Floor: 1 % 0 9 Cost of Construction: $ �, si , f> ®® Utilities: —Sewer t/Septic Building Height: -OWNER/LESSEE: CONTRACTOR::.;,.w Name - n) Lti••E , k Name: Kor . Address: 7d 2 S ���.. �� Company:. City: \o i'r cC, State: L Address: 7.02 Zip Code: ci 9rQ Fax: City: - State:_IEL . Phone No. 77a,'1.6 5r- III `% Zip Code: 9 qS-0 Fax: E-Mail: -5oSe. k(P '! •A -I kcZg_ Ilali; ,o a Phone No 7j E-Mail Se�Seq u C� Z�.6, � -� " Fill in fee simple Title Holder on next page (if differ e t from the Owner listed above) dF State or County License rSS �lug e a If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Name:i 41.o12 iOG'sZ f Not Applicable AAvr�te�A;1c� MORTGAGE COMPANY: Name: a lzarn.- 4 ,:•��$ Address: Zn-.1 -5 6yk Not Applicable - 1�ca �'� Address: vy '-1 N S^1 S City: 9A, R, 0-rc-g- Zip: 3 i) giia Phone _',77'. State: L -- g091 100 City: E+ 4 a-ce Zip: 34'1 h Phone: State: 772- 449-111 7 FEE SIMPLE TITLE HOLDER: _ Name: Address: City: Zip: Phone: Not Applicable BONDING COMPANY: Name: Not Applicable 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 commencing work or recording your Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA I STATE OF FLORID , , COUNTY OF S-�� L uW ' z COUNTY OFF kv$orn to (or affirmed) and subscribed before me of Ph ical Pre Online Notarization Swo n to (or affirmed) and subscribed before me of 7 Physical Presence Online Notarization a ce or or this —day of,(JdNf 2024 by this day of 2020 by Rd I rabm1V_ A644 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 Pro ed n Produ d °� otary Public (Signature of Notary Public- State of Florida.)(Signature of Notary K%iJ a'je OT(j)Askmon • GGan v�oF�o�o Expicres0ll/09/202254 2022 otary P c ate of Florida Commission No. Donna L� kman Commission No. My commission GG 174054 C G i(7065 Expires 01/09/2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 5/b/20