HomeMy WebLinkAboutBUILDING PERMIT APPLICATION—J
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All APPLICABLE INFO BE COMPL TED FOR APPLICATION TO BE ACCEPTED '
�MUST
Date: 3, to - ie- Permit Number: MVQ� • O% i l
.
RECEIVED
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Building Permit App icatidWAR 6 2019
Planning and Development Services Permitting Department
Building and Code Regulation Division
St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residen la
PERMIT TYPE: k BY SCANNED
PROPOSED 1NPROUEMENT LO TiON: #. ueie Coum#y
Address: 8'0.- SDAt-li L/0-F14 G f
Property Tax ID #: d --/ /ja-��` D � � �a " ��� % Lot No.
/ Site Plan Name: f01v✓ J°% ryP Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
(Alta to grtl� f T 12`X36QVfr tK/. !2a5 C1
r'<n GI �i'•'
G®NSTRUGION INFOR 10N;
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Additional work to be performed under this permit -check, tfia apply:
Mechanical Gas Tank Gas Pi in 1i"c' ''I:Shutters Windows/Doors
Generator. _Roof Pitch
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_Electric —Plumbing —Sprinklers! Tf%
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Total Sq. Ft of Construction: 3 (0Sq. Ft f First Floor:
Cost of Construction: $ v Utilities: —Sewer —Septic Building Height: /2
OWNER/LESSEE
CONTRACTOR:
Name /aw 6Jl1lossr
Name:
Address: ?VT- S. Yo-){ 6t'
Company:
City: % f-. P,'e (-ee F/ Stater
Address:
Zip Code: '3W 19 u/? Fax:
City: State:_
Phone No. %!2' J-2$'-2 2 ya
Zip Code: Fax:
E-Mail: ti R ci
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 HVAC is $7,500 or more, a RECORDED Notice of Commencement is reSiul.red.
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SUPPI = �NTA G ST t1lC�IQN EN W 1NFt3R
ATlON.
DESIGNER ENGINEER: _ fyot Applicable
MORTGAGE COMPANY: Not Applicable
Name: . r C if lol fin% , gyTz3 '�r'
Name:
Addr s a e.5
Ar,Y, Ire
Address:
City:-WACity:-WAW State.
City: State:
Zip:34-720 Phone_aa%
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Applicable
Name:
_Not
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 that
rules, or and covenants 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 Co ment must be recorded and posted on the jobsite
before the first inspection. If you intend to o cing, consult with lender or an attorney before
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Commencin r or recording our Notice cement.
a:
gnat a%of°Own r/ Lessee/Contractor as Agent for
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY C `D
The f rgoing instrument was acknowledge before "
COUNTY OF
The forgoing instrument was acknowledged before me
this day of YY1(P _a)�: 20 by
this_ day of 20_ by
ram,
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type ofLld€rtti ion
Type of Identification
Produced
Produced
ignature TM Public- State of Flo da U
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEM
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE Ip1
66
COMPLETED
ev. AIDREY B