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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLEs'°�cl FOR APPLICATION TO BE ACCEPTED Date: L --,> k Permit Number: SCANNED BY ECEIVED St. Lucie County 0 J 2019Planning En — Building Permit ApplicatR and DeGelopment Services EoenE fi�FftilEAR9 Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 ' Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential _I_ PERMIT TYPE: �jC fjt e. PR • P©SED IM ROVEME T LOCATION: Address: 4D Ia —elf L 9, d� erGe G 3 . Property Tax lD #: .24,,/I ,2 9— �l 01- 0 00 9 - 0 00/5 Lot No. 8 Site Plan Name: /; j ai / Il E 10644 to �-) 7q•-I1-� cDF Block No.123 I Project Name: DETA1LEl) DESCRIPTION Q WO K: (eD-(I(% 0�R-C tbCL— i(La CQDT J Wt r n 11� ('cis �a � 06 !n S CONSTRUCTION INFORMATION; Additional work to be performed under this permit — check all that apply: Tank Piping _Shutters —Windows/Doors _Mechanical _Gas _Gas Electric_ _ Plumbing _ Sprinklers _ Generator Roof 7 ' (2 Pitch Total Sq. Ft of Construction: Is) C Sq. Ft. of First Floor: Cost of Construction: $ S000. OD Utilities: _Sewer _Septic Building Height: OW R ER LE-SSEE: CONTRACTOR: Name a11 Oi G -e 1 SO Name: Addresss: ) ()(P S Company: City: a. p fe frt ev Stater Address: City: State:_ Zip Code:., Fax: Phone No. -- 4! — L- c,39 Zip Cod2`C' '"''' ' ` Fax: E-Mail: Phone No .•., Fill in fee simple Title Holder on next page ( if different �.' n Fri r' 'c yin p•i' 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. 5 PLEMENTALEON 111OLA N LIEN W INFARMATIQ DESIGNER/ENGINEER: Name: _ Not Applicable MORTGAGE COMPANY: Name: Not Applicable Address: Addr ss: 3 City: Zip: Phone State: City: Zip: IC1101 Phone: - State: 3 FEE SIMPLE TITLE HOLDER: Name: _ Not Applicable BONDING COMPANY: Name: Not Applicable Address: "' Address: City: City: Zip: Phone: Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the vio4 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 _dM J . A4L_&� Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA ft Luc /,✓- STATE OF FLORIDA COUNTY OF ;! COUNTY OF The forgoing instrum nt was acknowledged before me The forgoing instrument was acknowledged before me this / day of 2L 202Y by this _ day of • 20 by Name of person making statement. Name of person making statement. Personally Known k_ OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced If G Produced (Sig ature of NbtarfPublFlorid (Signature of Notary Public -State of Florida ) nlse Lopez CO 40n # GG082160 Commission No. _°r. �1r 1 Commission No. (Seal) Expires: May 26, 2021 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED