HomeMy WebLinkAboutBuilding Permit ApplicationAil APPLICABLE INFO MUST BEE�Ca.:r��ETED FOR APPLICATION TO BE ACCEPTZ.�,
Date:Permit Number:/
FREC
- Building Permit Appli ation FEB 2 2 2019
Planning and Development Services Permitting Department
Building and Code Regulation Division FL
2300 Virginia Avenue, Fort Pierce FL 34982 St. ,Lucie Co rlty r
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial esl ential
PERMIT TYPE: '4 A; T-1 0 V.,\ S
P QPaSE I P O�(EM �lU >, e ATIC•i ,
Address
Property Tax ID #: �7 �� �� O� 02 y- D Lot No. (- Qd3
Site Plan Name: Block No.
Project Name: CARPORT (4- GbRAG-E 04-L % LICD ON
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Additional work to be performed under this permit -check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters � 4indows/Doors
6e/Electric _ Plumbing _ Sprinklers _ Generator _11Roof ,l2Q.7 Pitch _
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: —Sewer —Se ptic Building Height: Fr
Name
Name: /n/V-,-L 6Lle7/I 1�7-1
Address: P_4,eT
Company:
�tl_r/.CLIAR/
City: 'SUArsMf9) ELLS State:
Address: ShILIIE`
Zip Code: &W _�!,V,9 Fax:
City: State:
Phone No. / �,�fQ; %a� - /�8�
Zip Code: Fax:
E-Mail:
Phone No
E-Mail
Fill in fee simple i We Holder on next page ( if different
State or County License
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.
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DPPT IL "roR
DESIGNER/ENGINEER: _
Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: P10L UA5-k CN
Name:
Address: 1F'3V S'U1 01ZRVQRF
City: /'�5 L.
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State: FX_.
Address:
City: State:
Zip: Phone 2 9a —
%gam— 9E 22
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 JOB SITE BEFORE THE FIRST
INOATNEBEFRECRCONSULT
TOT YOUR
INSPECTION. IF YOU
REODINdYOURNCO
COMMENCEMENT.
P0
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Signature rOwne %iMessee Contractor as Agent for 1��
Signature of Contractor License Holder
STATE OF FLORIDO
��
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The foIZoing instrum t was acknowledged before a -w a
The forgoing instrument was acknowledged before me
this day of 20M by m
this day of 20_ by
L i CrLt
:wi
Name of person making statement.
U;;t,;�;e:�'
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identificatio{'
Produced ('� Y] T-,ar � t -
) i
1
Type of Identification
Produced
(Signature of Vary Public- State of F orida)
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED