HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO N1UST:BE COMPLETED FOR APPLICATION TO BE ACCEPTED n
Date: ! B. PernSit,Number:
1.
.
: ... = Building Permit: Apipl.ication
Planning and Development,Services
Building and':Code Reguldtion Division Commercial Reside`ntiat.
2300 Virginia Avenue, Fort Pierce F134982
Phone (772)462-155.3 Fax. (772)462-1578 MG Funding
PERM IT APPLICATION"FOR:
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Address: ./.? '%�` LL� F�1. '
Property'Tax ID#.: "C a-�—� I` Lot No.
Block No.
Site Plan Name: ..
Project Name:
DtTAItt- RESCRIPTION OF UVORK
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N'ew Electrical Meter Second Electrical Meter (Affidavit required);
CONSTRUCTION VNFORIV'IATI0N
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Additional work to be performed under this:permit—check,all that apply'*,
._Mechanical _Gas Tank _,Gas.Pi'ping _Shutters Windows/Doors Pond
E ectric Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor
Cost of Construction::$ Utilities: —Sewer !_S.eptic . Building Height
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Dt1NER/LESSEE
CONTRACTOR
Name% zta � � Name r r
Address: Company:C_e,1A- 5
City:, 'i Knt. °" t'r6r _ State: : Address: C5. �a t
Zip Code: fax
City: 1 �AA6-��� State: ,
Phone No. � ���
f= .Zip Code: Fax:
Phone Nos
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Fill in fee simple Title.Holder on nekt page(if different E-Mail _
from the Owner listed above): 5tate.or'County-License_
If"value of,construction is 3500 or more,•a RECORDED Notice:of Commencement is required.
If value of HAVC is$7,500'or more,.a RECORDED Notice of commencement is requited.
SU�PLEIVIENTAI CQ[�iSTRUCTiON;LIEN t:AW IN�OR(UfA71dN ��� .� � � r�-
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: „NVot Applicable
Address: _ ... Address:
city:. State': City:: State::
Zip.,, Phone - Zip: Phone:
FEE SiMPLE.TiTLE HOLDER; Not Applicable BONDING COMPANY: _Not Applicabie
Name:
.. . Name:
Address Address:
City:: City:,
Zip: Phone: Zip:.
Phone:
OWNER/CONTRACTOR AFFIDViT Application is hereby;made to obtain ar permit to do.the:work.and installation-as indicated.
(.certify that no work or,installati.on has commenced prior to the issuance of:a per niit.
St.Lucie.County makes no representation that,is ggranting a permit will`authorize the permit hoiderto build the subject structure
which conflicts with.any applicable Homeowners Association.rules„bylaws or and covenants that may restrict.or prohibit such
structure, Please cons i t with yourHomeo.wners Association and review your deed for any restrictions which may apply.
Inconsideration of t(ie:granting of this requested:permit,I do hereby agree.that I will,ib all respects,perform:the work
in accordance with the approved plans,the Fiorid.a;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 ta another non-residentia f use
WARNi.NG TO:OWNER:Your failure to Record'a.Notice-of Commencement may result in paying twice for
irimprovements.to your property-..A Notice of Commencement,must be recorded;in the p"ublic records of'St.
Lucie County and posted on the jobsite beforethe first inspection. If you intend to obtain financing, consult
With lender or-an�attorne before commencing work or retordingyour Notice of Commencement.
nature of Owner/Lessee/Co factor as Agent for Owner
STATE OF FLORID
COUNTY OF
sworn to or.affirmed and subscribed before me,of . Physical Presence<or Online Notarization
this day of lf= 20at by
Name of person making stateme't.
Personally.known L---� R Produced Identification
Type . .
w duced
` ig at re o a Pub State.of Flo H
} MY COMMISSION#GG 313393
Com _ (Seal) t• e'
ab�dedThruNotary.EXP 'ts.
IRE$rMarch2p,2023
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REVIEWS FRONT ZONING S_UPERVf OR PLANS VEGETATION SEA TURTLE MANGROVECOUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COIViPLETED -
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