HomeMy WebLinkAboutBuilding Permit Package All APPLICABLE INFO MUST BE COMPLETED.FOR APPLICATION TO BE ACCEPTED IRS
Date: Permit Number: ��%
RECEIVED
�.L-U!,9I� ���. � FEB 2 � 2O21
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BuildingPermit Application St.Lucie County
p p Permitting
Planning and Development Services
Building and Code Regulation Division Commercial
ReSIClefltla�
2300 Virginia Avenue,Fort Pierce FL-34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:
Address: SZ-i1 i/vz G--_f 'F—D14
Property Tax ID#: Lot No.
Site Plan Name:�� `?x�� �� Block No.
Name:
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New Electrical Meter-�Second electrical Meter (Affidavit required).
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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: $ Utilities: Sewer —Septic Building Height:
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NameJfz—c'_ f�� .. MaXtfi`P Name:
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Address:144 54el / ! _ Company:
City: I T /�/8 State:_ Address:
Zip Code: �y'S( Fax: City:' St te:
Phone No.�9 — �� — 5,�2-� Zip Code: Fax:
E-Mail: Phone No
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 HAVC is$7,500 or more,a RECORDED Notice of Commencement is required.
MINN. 1
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.
-1 certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Count 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:.ropm 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 our Notice of Commencement.
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Signature of Owner/Lessee/Contra or as Agent for Owner
STATE OF
COUNTYOFORIDA
Sworn to(or affirm l-an ubscrib`e JSed before e of Physical Presence or Online Notarization
this�day of 2Q� q
JY1►�,1����I rn tJYY�'t y
Name of person making statement.
Personally Known OR Proclpc� Id e ifi ation
Type of Identification Produced li
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(Signature of Notary Public-State o Florida)
Commission No. (Seal) KAREN S. NIELSEN
State of.Flor•ida-Notary Public
*_ Commission # GG 207484
My Commission Expires
June'12, 2022
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DATE
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DATE
COMPLETED
Rev 5 21