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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPL_,_) FOR APPLICATION TO BE ACCEPTED ���( Permit Number: �� �) `, LCy Y Date: 3-6 — I 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: Address: SCANNED BY St. Lucie County Building Permit Application RECEIVED MAR 062019 Commercial Residentialesml �LDePartMent Fz (t P: e me � l 3 c f6 Property Tax ID#: 19ad _703 —CEO I$ -900— Site Plan Name: Project Name: Additional work to be performed under this permit —check all that apply: Lot No. Block No. a _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator Roof Pitch Total Sq. Ft of Construction: 300 Sq. Ft. of First Floor: 13©o a� Cost of Construction: $ Soo - Utilities: _ Sewer a t+ Building Height: OWR1ERjLESSEE: CONTRACTOR: Name ' acob V+v`50y\ Name: Address: D� 108' Dc"41& 5ti'"-+ Company: City: State: EL Zip Code: 3 �liN% Fax: Phone No. 77�'�7� `1760 Address: City: State:_ Zip Code = Fax Ph4one-No, . ,. .• E-MaiL Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Maih •c=i ;;r ..._ _ j State-or`Co`unty'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. NII LIPPLEM rie EONS ON I N LAW 1 197,13-11 DESIGNER/ENGINEER: Name: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Address: Address: City: Zip: Phone State: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Name: Not Applicable BONDING COMPANY: ZNot 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 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 Sin a of Owner/ Lessee/Contractor Agent for Owner Signature Contractor/License Holder as of STATE OF FLORIDA cc ++'' STATE OF FLORIDA COUNTY OF _S . o COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this L6 day of l pr& ), 201% by 1 A C-4 f ( ' A_AA o4I this _ day of 20_ by Name I person making statement. Name of person making statement. \ ' Personally Known OR Produced Identification " Personally Known OR Produced Identification Type of Identification Type of Identification Produced A� io,' �. ", "" Produced hat re of Notary Public-S. to of Florida) (Signature of Notary Public -State of Florida j Commission No. ;' gttf•; LAS§ h1RAHMING Commission No. (Seal) q ;•; IYCOIAI115510NgGG275M EXPIRE&Demni6ed20,2w REVIEWS FRONT PLANS VEGETATION SEA TURTLE MANGROVE ZONINGMO� S P R COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED