HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONo�
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All APPLICABLE INFO MUiSTT BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:—� — Q l 1 --
SCANNED Permit Number: Oyl
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tCOUNTY
S$. LUC e C®Gp$V RECEIVED
Building Permit Application JuL z 4 2019
Planning and Development Services Permitting Department
Building. and Code Regulation Division st, Lucie county
2300 Virginia Avenue, FortPierce FL34982'
Residential _X
PERMIT TYPE:
. PROPOSED INP.ROVEMENT LOCATION - -
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Property Tax ID #: 4504-602-0020-000-3 Lot No.
Site Plan Name: MYERS Block No.
Project Name: MYERS
DETAILED DESCRIPTION OF WORK..
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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:
Cost of Construction:
Sq. Ft. of First Floor: _
Utilities: . Sewer _ Septic
—Windows/boors
Roof Pitch
Building Height:
OWNER/LESSEE .-
_•CONTRACTOR;
--
Name_Scott Myers & Pamela L Myers
Name:.
i
Address:_ 17062 Jupiter Farms Rd
Company: PIONEER SCREEN
CO. INC
City: Jupiter State: -EL
Zip Code: 33478 Fax:
Phone No. .gam —
E-Mail:.
Addr s:U-01� 6W Pik q CX-e
City: (+-,c4.lL
Zip Code:
Phone No —
Fax:
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state:
Fill in fee simple Title Holder on next page( if different
from the Owner -listed above)
If Jalue.of construction Is S2snn er mnro . oernonen u..Z_
E-Mail
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State or County License l [ (p(QQj
If value of HVAC is $7,sca or more, a RECORDED Notice of rspmritencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNE ENGINEER: _ Not Applicable MORTGAGE COMPANY: of Applicable
Name:
Z Name:
Address:
Address:
City:
Zh Zip: Phone _ State: 55 ZiCity: Phone: State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: of Applicable
Name:
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 indicated.
as
I certify that noo work or installation has commenced prior to the Issuance of a permit.
which Is to conflict with any applicabletHome OwnerstAssociationir willauthorize
ylaws or and covenants that build
ay or prohibit such
restrict
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 the Florida
plans, 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 pos ed on the jobsite
before the first inspection. If you intend to obtain financing, consult
wi nder or an rney before
commencin or recording our Notice of Commencement.
Signal r o Owner/ Les Contractor as Agent for Owner Si n tty a of Contra /Licen a Holder
STATE OF FLORIDA L STATEOFFLORID I ,
COUNTY OF ST LUCIE
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COUNTY OF 1�.�d—
The for oing instrument was acknowledged before me The fpcQoing instrumeaEivas cknowledge efore me
this day of jTJ 20� by this f d-day of
20 by
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Name of person making statement. Name of person makings tement.
Personally Known OR Produced Identification X Personally Known OR Produced Identification
Type of Identification
Type of Identifi to
Produced_ D�RJTV�jF.-R T.iCENSF
roduced
(Sign attrrp of Notary Public - St of Florida) (Signature Ot Notary Public -State of Florida)
Commission No. ., a aORSODbaIRMINGH ommissionNo. /_'_� c� (� „4F. t�� •7Loeallitotgry pubic State
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+s,.• ,; Notary Public -State of Florid Francene Newma
'•,dr, h,+' 'My Com .Expires Aug 16, 20 2 M Com - s y ae
REVIEWS FRONT ZOItpNevou apo Expires 05/23@022
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DATE COLINTE EVIEW REVIEW REVIEW REVIEW
RECEIVED
DATE
COMPLETED
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