HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED t1
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Permit Number:
BY
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St. Lucie Coun %, [nJUN
ECEIVED
Building Permit Applicati 112019Planning and Development Services
Building and Code Regulation Division County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE:
DIMPROVEMENT
Address:
PropertyTaxlD#: •2 -J --A0D- 4oOlo—ado —S Lot No. 'b
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFORMATION:. - - • :
Additional work to be performed under this permit — check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
_Electric _Plumbing _Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 2500 '
Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name
3
Name:
Address: 9 n 'G.Mbp 1P d
Company:
City: - f7o'fi Ipi MCP State: —F�.
Zip Code:-9q&Jg5 Fax:
Phone No. '1 72 — 370 — 03q l
Address:
City: State:_
Zip Code: Fax:
Phone No
E-Mail: 01, C661
Fill in fee simple Title older on next page (if different
from the Owner listed above)
E-Mail
State or County License
...o...� .a w— l u n Ii 9 W V U1 IIIUIC, Y RC�URUCU IVOCICe OT LOmmencemenr is requires.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:' -
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: - State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ 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 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 ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or andpcovenants that may restrict or prohibit such .
structure. Please consult with your Home Owners Association and review yourdeed 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/ Lesse
ctor as Agent for Owner
Signature of Contractor/License Ho
STATE OF FLORIDA (r
COUNTYOF ��
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STATE OF FLORIDA
COUNTYOF StVG�P�
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s
The forgoing instrument was acknowledged before me
this � day of 201 by
The ff Ing instrume tl rl J wasacknowledge il,before me
this day of f 20 t4j by
Un l,) . i I . AJA
01 V
A b P U) E�
Name of person making statement.
Name of person making statement.
/
Personally Known OR Produced
Identification ✓
Personally Known OR Produced Identification
Type of Identification
DD,
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Type of Ida tifi at'o
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Produced
Produced
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Commissio No. •1�
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- Commission # GG 157258
Co Ek ires Dec 11, 2027
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REVIEWS
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SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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