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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE 11I FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r Date: ` i I Permit Nu 0 �� �C BY RECEIVE® a VI ` - .. - � St. Lucie Coun4V Building Permit Appl cation JUN 4 2019 Planning and Development Services Permitting Building and Code Regulation DivisionDepartment 2300 Virginia Avenue, Fort Pierce FL 34982 1 St. Lucie C unty, FL Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial PERMIT TYPE: PROPOSEDjIMF'ROVEIVIENT LOCATION_ ' , r;;;. �, v , r `;> Address:r)333 S:Ao Property Tax ID #: �� 1-1�,—��� W' trod-^ Lot No. 1 Site Plan Name: Block No. 5 Project Name: Additional work to be performed under this permit- check all that apply: Mechanical _Gas Tank _Gas Piping _Shutters Electric ✓plumbing�.,(�' _ Sprinklers _ Generator Total Sq. Ft of Construction: r LACJ• i Sq. Ft. of First Floor: _ Windows/Doors ✓Roof Pitch Cost of Constructions A - u�. ' Utilities ✓ewer _Septic Building Height OWNER"' L£ESSEE= 1, r.s; .- �X "� e Y f •�. Tr CO.N�TRACfiOR> Name Ada=HMi4ofNorNwesootF�� r0a,hr- Name: Ada=H=esotNoMwestFbrida, William Bry {\ Address: �C—XLLF 9f i-1.4. Company: Adam lianesofNport�hwestFtodda.I= twmul City: �(14.P D ���E State: �— Zip Code: -7�3 Fax:%D 55$3 Phone No. � •g�54. CyLP70 Address:2� &Lul=7vUZZE lam. City: (Stt1F_ �4 1! State: I_2.- Zip Code: 3 Fax: • q3` 1• 5533 Phone No t5a.934.0470 E-Mail: �Sln2fm �5@adGrn3hCvr�S COM Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail 17s1 [�Qsrht@ Q�cLivr.SLrvw _ ncm T State or County License &C MILIb 6F FI.- if varue or consirucuon Is �,lbOO 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. i Is, �Slt1PPLEMENTAMFONSTft111CTIONKLIENTCAVN INFORMATI©N ��vtEJd+.b DESIGNER/ENGINEER: _Not Applicable Name: 5^ �c..G 4.1�'aft 4`y �yy,} �J• t)e}4}.#'.i'SS 7 ' MORTGAGE COMPANY: _ Not Applicable Name: 1 Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: _Not 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 dr installation has commenced prior to the issuance of a permit. � which is inOconfll makes no any applicablelHome Owners Associationlrwill esabylaws or and covenants that mays estrictbor 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." Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder 6 STATE OF FLORID COUNTY OF STATE OF FLORIDI� COUNTYOF /Vhtclw The fo going instrument was acknowledged before me this day of UY� 20Z by The forgoing instru nt was acknowledged before me this day of , 20L by William Bryan Adams I Qtero;ur William Bryan Adams } G�Iiw- Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Type of Identification Produced ' �y�'•• SHELLEYA.SEPLILVED MY COMMISSION q GG 26 ei EXPIRES:�anuary25 ' a ure of Notary Public- a• . Personally Known _� OR Produced Identification Type of Identification ced , G✓'.., SHELLEY&SEPLI p . MY COMMISSION X GG r EXPIRES: January 25,2 z�.. ot,. re of NotaryP a - 6 74 3 Commission No.(Seal) Commission No. 707t�. Cj� (Seal) REVIEWS FRONT COUNTER ZONING REVIEW SUPERVISOR REVIEW PLANS REVIEW VEGETATION REVIEW SEA TURTLE REVIEW MANGROVE REVIEW DATE RECEIVED DATE COMPLETED ev.