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HomeMy WebLinkAboutBuilding Permit Application I All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 011r. Z irlp' Building Permit Application � Planning and Development Services Building and Code Regulation Division Commercial Residential V 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FORT12 -MR gmllffiffi&_ MINE Address: -_ Property Tax lD #: (�,9 ���C��^ ®po Lot No. Site Plan Name: Block No_ Project Name: RE I - � . - Teb".y 5 1 sh SeLu`T":� __ Pvf 4 ��lG� boo 3 New Electrical Meter Second Electrical Meter (Affidavit required) '2%t 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 Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ co Utilities: —Sewer _Septic Building Height: s�r.._; "�` �" Name Name: Addre Company: v� City. �JQ . IState ' Address: Zip Code Fax: City: r Stater i Phone No. Zip Cod '-zA Fax: E-Mail: Phone No ? i J Fill in fee simple Title Holder©n next Page{if different E-Mailjjtrwa'o y from the Owner fisted above) State or County License G4G 011; 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. I i DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: .Address: Address: City: State: City: State: Zip: Phone 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'rep.reseritetion that`is granting a.permit will authorize the p.e'rmit'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.o.n the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commen' cing work or recording our Notice of'Commencement. Si a,ure of 0 er/Lessee/Contractor as Agent for Owner S TE OF FLORIDA b�3UNTY OF S} L u,C�r Q- Sworn to(or affirmed) and subscribed before me of Physical Presence or Online Notarization this Ae day of (30tob4r 209 1 by Jo h, 7o\co bs Name of person making statement. Personally Known /` OR Produced Identification Type of Identification Produced (Signature of Notary lic-State of'Florida) Commission No. e°P"Ypty Motary:PutilicStateofFlorida Casey BiWey wi u My CommissiomGG 906i38D �rFo��o�: Expires 0812212023 ; • j REVIEWS FRONT ZONING _ SUPERVISOR PLANS VEGETATION SEATURTLE: MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev 5 20 21