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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLEi'eu FOR APPLICATION TO BE ACCEPTED Date: Permit Number:BY l SCANNE6 _ II RECEIVED St. Luce County i -- _— Building Permit Applicat on OCT 0 0 ?pt9 Planning and Development Services ST. Lucie County, permitting Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553—Fax: (772) 462 1578 - Cofl merC(al_ Residential PERMIT TYPE: PROPOSED IMPROVEMENT LOCATION: Address: 5 S (i �ai Yvl 1='t-to �f� PI e re-e-t3y 9 K2 / 1 %vlol'1a'R2y-er E5"t Q56?S �Fl. Property Tax ID #: 3 1 0 2-- ( / � — z + 000- -ly Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCR PTION ©F WORK: n V'e-- J>L[ { S h e ' Z Lf CONSTRUCTION INFOR ATION: 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: 2 0 8 Sq. Ft. of First Floor: Cost of Construction: $ 7 .J 00. Utilities: —Sewer Septic Building Height: O W NE'R/LESSEE: CONTRACTOR: Name Name: t !� Address: �{ Pry) m `1 e u ! Jr . Company: pJr1 fp�� City: f. h' l •c/'GP State: FL Address: - Zip Code: 3 tf rd 2 Fax: City: State:_ Phone No. 772 .577-123 celSls 40 Zip Code: Fax: E-Mail:SWo1061101.,f 1 0MPhone No Fill in fee simple Title Holder on next page ( if different E-Mail from the Owner listed above) State or County License 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. Not Name: Addre: City: l Zip: 4 TITLE-HOLDER: - — Not Applicable M. Zip: MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: COMPANY: _Not Applicable Address: Zip: Phone: OWNER/ CONTRACTOR AFFIDAVIT: 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." Signature of Owner/ Lessee/Contractor as Age. )for for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 5k_ LJmQ COUNTY OF The forgoing instrument was acknowledge*efore me The forgoing instrument was acknowledged before me thiA_ day of b ck 20 N by this _ day of 20 by 64m.-o4-� �o\kdw31�� Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced ';1y 4 Produced (Signature of Notary bli Sit „,.c, Florid® iSBIDNkGGOR2B23 ;' Si (Si gnature'of Notary Public -State of Florida) :$�"`•f: httc Commission No, nZ �� y' V. Decam6u 18, 2020 ; Nola toll JJJ ommission No. (Seal) ,epJl'o REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED nev. Z/i/iy