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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLET,ZD FOR APPLICATION TO BE ACCEPTED It--_qoa sn Date: —� /— -1 Permit Number:1-9 Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT TYPE: RFCFrV�O FFB 2 zo Building Permit ApplicationeS<<4Ce 9oepd 'e Cow ty/n�©nt Commercial Residential Address %i» L fi.,n,oSCw L.aa.n, i Property Tax(DINER Site Plan Name: Project Name: 4,-S.& Ai nrz. Additional work to be performed under this permit -check all that apply: _Mechanical _ Gas Tank —Gas Piping _Shutters _ Electric _ Plumbing _ Sprinklers Total Sq. Ft of Construction: Sos-M Construction: $ L _ Generator Sq. Ft. of First Floor: `5 Utilities: _Sewer _Septic Lot No. Block No. Windows/Doors Roof Pitch Building Height: OWNER/LESSEE: CONTRACTOR; n 0 Name: Address: s- v ✓ F Company: City: 9�i„� m F3 G,4 T �— Zip Code: .3oi q c7 -7 Fax: Phone No. ? ?a - *� Ti - 3 State: Address: City: State:_ Zip Code: Fax: -Phone-N"d' E-Mail: lo e—'f r it C/-L G � VCR a'• Lis Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail State or County License 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. SUI�PLE1VtE •QNSTiR 1ON WHEON11MVNF�iMATI+ 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 is in conflict with any applicable Home Owners Association bylaws rules, 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 INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Q , Signature of Owner essee/Contractor a Agent for Owner Signature of Contractor/License Holder STATE OF FLORID �(( �� COUNTY �l STATE OF FLORIDA OF t t ICI COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this -1-7day of by this _ day of . 20_ by , {20�_q Name of person rfiaking statement. U Name of person making statement. Personally Known OR Produced Identification Personally Known - OR Produced Identification Type of Identification Type of Identification Produced Produced %I.� (Signature of Notaryubl' - I i a4GN (Signature of Notary Public- State of Florida ) ° "' LLEE Commission No. =:°`"� •`��;;Stat �t)ublic Commission No. (Seal) ,� •E Commission* 79M My �P� ComREVIEWS FRONT ZONING PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.