HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: q — 1T Lq Permit Number: 1 L� �J
SCANNED
BY
• St. Lucie County
Building Permit Applications
Planning and Development Services
Building and Code Regulation Division ��9p 101
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT TYPE:
PROPOSED
IMPROVEMENT LOCATION:
Address: 9. 60q Cct (,J,,,.. z � � T
Property Tax ID #: 33DO0,C� Lot No.
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Site Plan Name: � Block No.
Project Name:
DETrAILEO DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- heck all that apply:
_Mechanical as Tank _Gas Piping _Shutters —Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost ofConstru tie : St,5CK2,• .10 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRAC«TOR:
I�me
G :V 5eo�' t,u : '.�c`
Name:
Address:
S(W (, �ISI^',Ne C�
`70 Z" bl
Company: .` (UJA••• :-
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y: Po (' °' C': =:Y' State: L
Address: �` '" S lr% (�rvG �k w t C
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City: f•S.'L -' - State:IFL
pCode:' 3`�•gS0 ' ' Fax:
JF�F'�
one No. -.._ ::-_ _ .:,..._.:�...-.•_
Zip Code: Z�alg 4 Fax:
Mail:
Phone No 7
I infee simple Title Holder on next page (if different
E-Mail ��c( rl PI'vv.1 ti 4 Ca -
State or County License C [ C I' q, . S S7
fr,
m 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.
3 PPLEM TAL CONSTRU
DESIGNER/ENGINEER:
Name:
ION LIEN
_ Not Applicable
OR111 1101111211:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City:
Zip: Phone
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
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 reviewyour deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that Iwill, 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
LcmucK uK Am Ai I vKmci ecru KC mcI uKuld4 l uuK Ku I K.0 ul
0 /�,X /- d�
as Agent for Owner P1 Signature of Contractor/License Holder
STATE OF FLORIDA I STATE OF FLORIDA
COUNTY OF 51- Uu GISZ I COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this �dayof 201P�by this M—dayofr:St1. 20_Aby
F,;�a grn Q!Lja force or-G rl U.' W C�
Name of person making statement. Name of person making Aatement.
Personally Known OR Produced Identification
Type of Identification
Produced a —
Commission # GG
My Commission
Personally Known OR Produced Identification
Type of Identification, — , - .. r.
(Signature
REVIEWS FRONT ZONING SUPERVISOR I PLANS I VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW I REVIEW REVIEW I REVIEW REVIEW