HomeMy WebLinkAboutphillip smoak permit apAll APPLICABLE I FO M ST BE COMPLETEb FOR APPLICATION TO BE ACCEPTED
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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: � WjhCiOW rep�aCE'I1'lE'flt SIE', t0 SIZE',
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Address: 5051 N HIGHWAI' A1A .Unit 17-3
Property Tax ID #: Lot No.
Site Plan Name: Phillip Smoak Block Na.
Project Name: Phillip Smoak _ __ _
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indow replacement sie to size to IMPACT SINGLE HUNG
New Eiectrical Meter Second Electrical Meter
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Additionai 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:
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Cost of Construction: $ �1 "i��� Utilities: _Sewer _Septic Building Height:
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Name: i�1.� h. � ��"i � � �
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Company: ) i 1 ���'�'� �1ii/�.i1.0a.�. d- p��
City: �1' �,�-� State:'"
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Zip Code: bl � Fax:
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E-Mail:
Fill in fee simple Title Holder on next page (if different
E-Mail ���x �$ ` DA- S��t�1'L�'D
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tate r County License__ � 1�C�.D� . G ,ice
from the Owner listed above)
If value of construction is 2500 or more, a RECORDED Notice of Com encement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER
Name:
Address:
City:
Zip: Phone
fEE SIMPLE TITLE WOLDER:
� Name:
Address:
� City:
Zip: Phone:_
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Not Applicable
State:
_Not Applicable
MORTGAGE COMPANY
Name: _
Address:
City:
Zip: _ Phone
BONDING COMPANY:
Name: —
Address:
City:_----__�
Zip: Phone:
_ Not Applicable
State:
_Not Applicable
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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 i•, in conflict with and applir.able Home Owners Assoualion rules, bylaws or and covenants that may restrict or prohibit such
structurn. Please consult with your Home Owners Association and review your deed for any ro_strictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all resper_ts, perform the work
in accordance with tt,e approved plans, the Florida Building Codes and St Lucie County Amendments.
Thr- following building permit. applications are exempt from undergoing a full concurrency review: room additions,
accesson� stnrctures 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.
Luci�,,y�SO,<it� end posted on the jobsite before the first inspection. If you intend to obtain financing, consult
wi ,Teri ran attorne before commencin work or recordin our of encement.
Si�Katirr- o' Owner; Lessee/Contractor as Agent for Owner Signature{of'�ontr�cfor/License Holder
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STATE Of FLORID STATE O FLOI�IDA
COUNTY Of � COON OF � ''
Sworr a for affirmed) and subscribed before me of ' Sw rn or affirmed) and subscribed before me Of
��iysical Presen or Online Notarization ,�h ysical Presence r Online Notarization
this � day of 202� by this S day of 202� by
i Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification � Personally Known � OR Produced Identification
Type of Identification .� ���� ..6 i •-63 � Type of Identification ,}7
� Produced Produced ("l.
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(Signature of Notary - Signature of Notary P = to of n � SAN R KI M
��;;,•,,,, NDRA KIM ,�;��r'""4� Notary Public r ate of Florida
,.�� Noterylpuglic - Stste of Flori _ Commissio GG 944159
� Commission No. - '� Cor i�tgga6k�iiar� M GG 944159 ommission No.
;; My Comm. Expires 01-05.202 My Comm. Ex i s 01-05-2024
_',,,1a v��� Bondrrd Throuch ` Bonda rough
Amrrrign A. oci�tiun of Nur�ri�
--- — ',�r�'rr�1`` i ion of Notaries
REVIEWS FRONT ZONING - LANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVI=D
DATE ---- --- -
COMPLETED