HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (�
Date: SCANNED Permit Number: I
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B i Isneas
St. Lucie County
- _ Building Permit Application
Planning and Development Services
Building and Code Regulation Division --
2300 Virginia Avenue, Fort Pierce F134982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE:
Address: Sg3to Palmg-k-- Ave,.
Property Tax ID#: 3L10y- Sol- 0558-030-, Lot No. II
Site Plan Name: H C De r-r )ott, Block No.
Project Name: 0� Tp e rmntb
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:: Sq. Ft. of First Floor:
Cost of Construction: $ .'S 1. 000 .00 Utilities: —Sewer _Septic
Windows/Doors
T Roof Pitch
Building Height:
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Name John M`_De rmor;t
Name: V1+01i ( r6krLi
L
Address:5H3& Rilmeq—tt0 46
Company: PmiS N
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City: F1 • Pi-e-ra, State:
ZipCode:3LIgga- Fax:
Phone No.
Address: 1544 SE Cmyi iT !h4 Dr.
City: _PSL
Zip Code: 31LIa9")
Phone No 1
State:
Fax: �"
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E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
State or County License
C(I 145 6zu
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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�suPPLEMEI a ,foi STR c �, 3 1 (�La , �I
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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 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
"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."
Owner/ Lessee/Contractor Agent for Owner
Signature of Contractor/License Holder
koftere of as
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF S4 LIACIP
COUNTY OF _ to Pi
The forgoing instrument was acknowledged.�before
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The for oing instrument was acknowledge before le. c
thisA,dayof .)Ullf 20 i by
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this�dayof JUYI� zo by
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Name of person making statement.
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Name of person making statement.
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Personally Known ✓ OR Produced Identifica
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Personally Known V OR Produced Identificati
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Type of Identification
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Type of Identification
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Produced
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Produced
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(Signature of Notary Public- State of Florida j
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(Signature of Notary Public- tate of Florida)
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Commission No. Seal
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Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
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