HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: l -� 2 Permit Number: cz2p%
^I., RECE�V�D
COUNTY
Building Permit Application,0N I 2p22
l
peto"t%n9M
Building and Code Regulation DivisionSt'
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE: L.1—) 1 , V
• ► S � ' Q M a
Address: 0aN. D fy Z)So
Property Tax ID #: .5 �' d —� Lot No.
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Site Plan Name: Block No.
Project Name:
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Additional work to be performed under this permit -check all that apply: /
_Mechanical _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ ��-, l t Utilities: _ Sewer _.Septic Building Height:
ER L 3WS
CO CTC1R•
Name &t►'UVa-
me: DAV (0, r4A&sKA&L
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Company: 4AlltiO !3. P%ArSJJ+K G. G. ite.
State: n}� :
Addr�sr�•°fjic�-.:rto N woo o AA
City.: r! , is 1 State: F t;
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i� Zip Code Fax: ---- ? .,
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E-Mail: ,t R. ,;Phgt
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Fill in fee simple Title Holder on next page ( if different
E-Mail cl n„ / '.. @ T .,✓�-f
State or County License G e- D S"i -7 r B
from the Owner listed above)
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.
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:.. _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:_
Address:
City:_
Zip:
Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to'obtairi 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 Countyy 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 tliat l 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH, L YOUR DER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Sign re of Contractor/License Holder
STATE OF FLORIDA
ST LLIC C
STATE OF FLORID
�-
COUNTY OF �
COUNTY'OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
i
this day of N 0 d 20 2( by
this I L4 day of , 20 d by,
Name of person making statement.
Name of person making statement.
Personally Known ✓ OR Produced Identification
Personally Krrown- V1 OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
� o
�
—(Signature of.Nota y Public -State of Florida ).: '
(Signature of otary-Public-St e 9 on a
,� �o, • BEVERLY DIANE AARSHALL
:.
Commission No.
�8a l =°���r: Nota • Public -'State o4 Flori
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; «xY eal) BEVERLY DIANE MARS
niLQrn ission No. o (SDI mission k HH 082192
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?°��'; Notary Public, State of
"F commission # I H 08
lorida�4:V My Comm. Expires Jan 19, 2C
192 Bonded through National Notary A
•••.•,pvr%R,- my
omm. Expires Jan
9, 2025
REVIEWS
FRONT' : .,
ondeqzz
o
ary S
VEGETATION
SEATURTLE
MANGROVE
REVIEW �
REVIEW
COUNTER., _
REVI
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2/7/19