HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
(° Date: i K- ) q Permit Number:
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BY RECE�XV
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Building Permit Applica ion JUL 18 2019
Planning and Development Services _
Buildingand Code Regulation Division Permitting De artM(
2300 Virginia Avenue, Fort Pierce FL 34982 S u Ci�0lJ n t r Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Re y F
PERMITTYPE:
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PROPOSED
1IMPROVEMENT LOCATION:
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Address: IV5 L. �C ex v--nL, ,Q-A 7c ilE Z�
Property TaxID#: 3'-h-'�-p.�'CD�I1��O`b ll-wC! ;� LotNo. D ,
Site Plan Name: Block No. o� b
Project Name:
CONSTRUCTION
Additional work to be performed under this permit - check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters —Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: � ( Pdd� Sq. Ft. of First Floor:
Cost of Construction:$$ )d` Utilities: _Sewer _Septic - Building Height:
OWNER/LESSEE:
CONTRACTOR
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Fill in fee simple Title Hold on
next page( if different
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State or County LicenseC QC. C)3c1 S 5C SC
from the Owner listed above)
It value of construction is $2500 or more, a RECORDED Notice of Commencement if required._,
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required. `
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/E GINEER:- _
m Nae•:' • L 5 S:r:�� � r
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address?! 5:N"Fes' 4
ro o s
Address:
City:` 6eeyw en tvt 66-
Zip:t Va Phone 7R6T630
State:
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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 Counttyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in confliR 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 INTAEIND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY IBEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
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Sig of Owner/ Le e/C ractor as Agent for Owner
Signatur f Co ra for/License Holder
STATE OF FLORIDA -
STATE O I t
COUNTY OF S+ Luca e
COUNTY OF r 1, n
The forgoing instrument was acknowledged before me
The fo aing insent was acknowledge before me
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this, to-clayof S'ulj 2011 by
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Name of person making statement.
Name of person making statement.
Personally Known X OR Produced Identification
Personally Known s OR Produced Identification rai.—
Type of Identification
Type of Identification '
Produced
Produced
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DATE
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DATE
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