HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICAB (q! O MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: rF Permit Number:
ii`W y RECEIVED
Building Permit ApplicatikMAR 18 ?019
Planning and Development Services '1
cltaCauntBuilding
and Code Regulation Division ' -?� y, Permltting
2300 Virginia Avenue, Fort Pierce FL 34982 1
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential z
PERMIT TYPE: SCANNED
PROPOSER`'((Vlf'ROVEMENT CO
Address:
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2
Property Tax ID #: Lot No.
Site Plan Name: rP coop Block No.
Project Name:
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DETAILED-6'FSCiRIPTION OF WORK:-'` °t
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CONSTRUCTION INFORMATION
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Additional work to be performed under this permit — check all that apply:
_Mechanical _Gas Tank Piping
_Gas _Shutters —Windows/Doors
_Electric .., —Plumbing_Sprinklers _Generator ✓_Roof Pitch
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Total Sq. Ft of Construction: ';5' 6 Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: _Sewer _Septic Building Height:
OWNER70tQcrr: J
CONTRACT`.OR:
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Name ' rvv1i _ IJL J
Name t✓
—
Address: l
Company:
City: State.
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Address: 1Q Sl
City: —k State'.
Zip Cade: Fax:
Phone No. —
Zip Code: 0a 'g— Fax:
E-Mail:.,
Phone No
Fill in fee simple Title Holder on next page (if different
E-Mail f J'CAX1 0
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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SUPPLEMEIyTALCONSTRUFTION,LiEN LAW .INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone: — —
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Applicable
Name:
_Not
Name: , J
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.
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St. Lucie CountyY makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in c0ntlict 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 INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
e&sseactor
Signat a of Own r/ as Agent for Owner
S' ature of Contractor/License Holder
STATE OF FLORMA-1
STATE OF FLO A
COUNTY OFF (�
COUNTY Of�(�
The fo in"nstru nt was acknowledg efore me
this day of , 20 by
The f Instru nt was cknowledge"efore me
this day of G�L 204, by
0 1l)k ri
Name o person king statement.
Name of person making statement.
Personally Known � OR Produced Identification
Personally Known �oduced Identification
Type of Identification
Type of Identification
Produced
Produced
gnature of Notakj�leivTtateN@fa�f P4j41ft )ilaie of Flprida .
41?". Amanda P Sanderson
Commission No. • My com�GG 211266
• p gives 6 22
(Signature of Not t I' �- f I r'd
�A
Commission No. ,ij� Notary Public �lpr{Ca ,
a1anda P S n
.,v My Lr •unission GG 211256
ir86 04125 0
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEATURTLE
REVIEW
IMPAE
REVIEW
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DATE
RECEIVED
DATE
COMPLETED
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