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HomeMy WebLinkAboutBuilding Permit Applicationr r-I All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (� ( t�(� Date: - !'� Permit Number:- � DA- "-� lq c e q. co-� ay U t1`® O d 033 3 t�fJ U.' ,B . Building Permit ApplicationN Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential PERMITTYPE: Plumbing & Electrical, PROPOSED INPROVEMENT LOCATION: Address: 8850 Indrio Rd, Fort Pierce, FL 34951 Property Tax ID #: 1314-23.3-0001-000-0 Site Plan Name: Indrio Road Park/Schoolh(juse Project Name: Indrio Road Park/Schoolhouse Restroom Installation 'DETAILED DESCRIPTION OF WORK: ?, ; Lot No. Block No. Construct pre -manufactured restroom building 10'-8" X1 T-6" X 9'-8" and install electrical, plumbing, septic and sewer connections. Connect electrical, plumbing, septic and sewer to local municipality. CONSTRUCTION INFORMATION: - Additional work to be performed under this permit -check all that apply: Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors I, )C Electric $ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: 187 Sq. Ft Sq. Ft. of First Flo Cost of Construction: $ �, J�©� Utilities: ( Sew r )C Septic Building Height: OWNER/,LESSEE:CONTRA . Name St. Lucie County BOCC Name: Owner Builder Address: 2300 Virginia Avenue Company: St. Lucie County BOCC City: Fort Pierce State: _ Address: 2300 Virginia Avenue City: Fort Pierce State. FL Zip Code: 34982 Fax: Phone No. 772-462-1100 Zip Code: 34982 Fax: E-Mail: Phone No 772-462-1100 Fill in fee simple Title Holder on next page (if different E-Mail from the Owner listed above) State or County License If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. SU FLEMENTAL.CONSTROCTION "LIEN 1AW INFORMATION •. < � a m'.. � . .., _.,� ,. �. � - ,. ... ,, '^ '. ,; _ .� +,� ,. '.k '� ':;. � r' �- �s bra°. DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: LEESBURG CONCRETE Name: Address: Address: 1335 THOMAS AVENUE City: State: City: LEESBURG State: FL Zip: 34748 Phone 352-787-4177 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 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 your paying twice for improvements to your property. A Notice of Commencement must be recorded 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 vour Notice of Commencement. . Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF S T ZLCC I COUNTY OF The forgoing instru ent was acknowledged before me The forgoing instrument was acknowledged before me this 9-;day of 14P2i1,. 20 11 by this day of 20_ by L�oT't' UxQU f I �G� Name of pers n making statement. Name of person making statement. Personally Known I OR Produced Identification Personally Known OR Produced Identification _ Type of Identification Type of Identification Produced Produced Signature of Notary Public- S to r J LISSA S. BOECKEL ture of Notary Public- State of Florida ) Commission No.��icf7 q=rgjssion#FF979475 Com ission No. (Seal) X`p�to� April 6, 2020 Y' '„i+�'' Banded ThNTroyfainlnsurance880. 85.7 119 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED '` l DATE COMPLETED ev.