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HomeMy WebLinkAboutBuilding Permit - updated change of contractorAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: Z l O l (5-70 t Building Permit Application Planning and Development Services Building and Cade Regulation Division Commercial Cial Residential 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 CBDG Funding PERMIT APPLICATION FOR: Address: +� Property Tax ID #: 7 Site Plan Name: 60 I — ©a ['i— Lot No. Block No. Project Name:---' _--y-COV7, �K_ �✓ t� - ' �^' - -- New Electrical Meter Second Electrical Meter (Affidavit required) 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 L7� Pitch Total Sq. Ft of Construction: �Z.-�i e.24!�? Sq. Ft. of -First Eloor: Cost of Construction: 77 9 000 Utilities: —Sewer —Septic Building Height: p.v.fQ-r.�1f.f5z'fb+Nn:::§^ :"i`,'".k'"'tY*r.ay.,.'��"e'i':�','''4N Ri *s�:UTy' .�.`. ° x.�irW �v�> w�{ �+ •Tr I �r.dIrs,Z'r7zk T:-`'a;C`R � r'V ..,r.''F§`.' axL•_�TF.._.tS4.4q�•t_ s::E-pr,.r.7E." sy�° .A;+q»gYiF�t��J:'r5`y iEa-s.R+..�?�, ?;i zry.~ F ..__rr.+Fr .leC�v :C7�.D. ..� Name Name. Address: Company: Address: � City: State: — Zip Code: Fax: City: State�L� Phone No. Zip Code3�!2in) Fax: E-Mail: Phone No �— E-Mail Fill in fee simple Title Holder on next page ( if different from the Owner listed above) State or County License(gr C, , k':F='2_l.�� �- If value of construction is z5ou or more, a HtLUKlJtU Nauce or commencement ,s requireu. If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. 6�iiliG k a ; NINE F... >.=y7c• cy r �( ey .�rr: Y� ►.q� [y` ^j{��i,ray'�• 11-i �, ::n+rtt• ,:.tiu'tx�T;Y-1' �' sP �{i��..fdd'��'„' .J ,., =;;�r_y T �1- , 1 � `• :���..j`ti�F��'U�; -.�ESl6i1lER NINE .• 3.4 i__�C�.:lre�` 1irj.rli• ..-". •qu .CVl�r `3re�i-i3'.. 'l5'. J 1� * M - _ `;.1 1 NGINEER: Not Applicable Name: MORTGAGE COMPANY: Not Applicable i , Address: Name: I City: Address: State: City: $ta#e: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: - Name: _1Vot Applicalale ! Address: Name: —+ City: I Address: --- R 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. { Lucie County makes no representation that is granting a w 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 z:u�h structure. Please consult with your dome Owners Association and review your deep: for any restrictions which may apply. In consideration of the granting of this requested permit, I do hereby agree that I v •11, in all respects, perform the work +. in accordance with the approved plans, the Florida Building Codes and St. Lucie co..nty Amendments. ' The following building permit applications are exempt from undergoing a full concurrency review: room additions, I ' 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. I, Lucie County and posted on the jobsite before the first inspection. If you intend to obtain Financing, consul i with lender or an attorney before commencing work or recording Your Notice of Commencement. w i Signature of Owner/ Lessee/Contractor as Ngent for owner , STATE OF FLORIDA COUNTYOF f± LU. , ''r I Sworn to (or affirmed) and subscribed before me of Physical Presena. or Online Notarization this day of z6 by I I Name of person making statement. Personally Known. OR Produced Identification Type of Identification Produced_i (Signature bf Notary Pubi[ic- State of Florida ) Commission No. (Seal) i r r I REVIEWS FRONT ZONING i COUNTER I REVIEW I HEATHER BURFO" D State Of Florida -Notary i ipti 3 onUO I17 DATE ' I RECEIVED I l DATE I COMPLETED SEA TURTLE MANGROVL I REVIEW I REVIEW r , I