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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABILE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �Is`� �°` Permit Number: _ ` `�� f�� a ,I SCANNED RECEIVED . �. Lucie Cau*, JUL 1� 8 ? 019 �A Building Permit Applica ion I Planning a d Development Services ST. Lucie C,g4ftLyf Rermlti lnq Building a d Code Regulation Division 2300 Virgi4ia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential C! FPERMIT�TYPE: Q dad oh a:0-4" V-`de -1, Address:1I f / %�/dv 11W —V{�}- Property flax ID #: 1414 - �`� — 000,3 —e0oCo Lot No. Site Plan ! ame- C 1V679 %4I$CALO 5�//IF Block No. Project Ze:yAV'11&7`A Pam/ Additio Ilal work to be performed under this permit - check all that apply: _M�eI chanical _ Gas Tank —Gas Piping _ Shutters E ectric Plumbing __ Sprinklers _ Generator Total S I. Ft of Construction: ��o Sq. Ft. of First Floor: Cost oflilConstruction: $ /5 coo. oa Utilities: _Sewer _Septic Windows/Doors _ Roof Pitch Building Height: © "SERR/LESSEuE: CONTRACTOR: Nam K�V�� APAW + ��� Name: A rZM1� � � 7yz_c7 o Company:410TAYC 6VAf8 c1�'-!`ZO•cJ Adder ss: C.0 R2, �/`— City: 'I A44,AA41 State: FL- Zip ode: 3_5 /4'�4 Fax: Pho Ile No. (fl 5-1 2 — 8 T Address: 15360 gtO 'W City: /f'lAWY State: 'Fl- Zip Code: .501-7-5 Fax: Phone No gG E-M il: Fill i fee simple Title Holder on next page (if different fro the the Owner listed above) E-Maih�S��QC� State or County License ,3 3 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. If val le of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. E NTAL DESIGNER/ENGINEER: _ Not Applicable Name: .,,,.,.Name: MORTGAGE COMPANY: _ Not Applicable Address: - ..,.Addr'ess: City: State: Zip: Phone City: State: :Zip'` � Phone: FEE SIMPLE TITLE HOLDER: Not Applicable Name: BONDING COMPANY: Not Applicable 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 I 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 YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." I � � III _.. �•, _ i Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/Lic nse Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF O`er a COUNTYOF 6N— The forgoing instrumen was acknowledged before me The f rgoing instrument was acknowledged before me this n day of 20� by this �day of 10 \ Y 20_%A by LID Y,LJY Name of person making statement. Name of person making state ent Personally Known OR Produced Identification V Personally Known OR Produced Identification Type of Identification o�w;PuaDANNA COLON o Type of Identification Pre4uced k— misslon # GG 250804 Produced * EXPIRES: August 20, 2022 %OF 1-0 Banded Thru Budget Notary Services (Signature of Notary Public- State of Florida) (Signature of Notary Put�I.i SY to of F M, MARIELAVI= Q t COMmlosic N # GG 02202�3 { MY I Commission No. "(Seal) 2 0 I E ec er,2020 EXPIRDb96 Commission No. Cry a Und.r ,Aare Bonded7h N� ublic s REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER, REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.