HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONS All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ��
Date: Permit Number.-a Doi • (0
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` .- Building Permit Application
Planning and Development Services j
Building and Code Regulation Division Commercial Residential V
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax:(772)462-1578 CBDG Funding
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PERMIT APPLICATION FOR:
`PROPOSED IMPROVEMENT LOCATION:
52 U ) chr-u E r>� �er�e � T I Z4 qy2
Address: G' ��I/_r/j�(,4 p
Property Tax ID#: �y NSD J D(o Z IOQ,��F Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK: ., .
-lee rn0V'- shi»a/'- c and li,s ha n�ls'
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New Electrical Meter Second Electrical Meter (Affidavit required)
'CONSTRUCTION]N FORMATION:
Additional work to be performed under this permit-check all that apply:
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_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors and
Electric _Plumbing _Sprinklers _Generator ZRo�of -�Pitch
Total Sq. Ft of Construction: 3 b O Sq. Ft.of First Floor:
Cost of Construction:$ Utilities: —Sewer _Septic Building Height:
OW , ERILESSEE CONTRACTOR:
Name Mor Ce-I a PY c4nCL;z Name:
Address:_cjZp/ C,l'y_3 Jgyt�P Company: !
City: 'FDr IZ 'K ere e_ State: 1_ Address:
Zip Code:�3C qk7 Fax: City: State:
Phone No.777-532,9 0 O& E- Zip Code: Fax:
Mail: Sande 222 O 2 R 9 qwa CQ 0:2 Phone No
Fill in fee simple Title Holder on next page (if different E-Mail
from the Owner listed above) State or CountylLicense
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.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
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 representation that is granting a permit will authorize the permit holder to build the subject structure
which conflicts with any,applicable Homeowners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consu t with your Homeowners 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 concurrehcy 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 on the jobsite before the first inspection. If you intend;to obtain financing, consult
with lender or an attorney before commencing work or recording your Notice of Commencement.
(,A"C, (Q��� c ,n t d c 2
Signature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF �� - (gip iz AO--
Sworr�o(or affirmed)and subscribed before me of Physical Presence or Online Notarization
this ay ofI r 1 !1 .20a__1-by
car C►l-' �Azm a QA—
Name of person making statement.
Personally Known OR Produced Iden ification
Type of Identification Produced �,
(Signatur I '
ELLEN VAUG
"PYP6e '- State of Florid No ary Public
Commissi _ NEW 270079
`= Expires
� a`c M Com6missaippn ExAp
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev 20/21