HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONV.
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: \I -v%g*\ Permit Number: 1\^ 43CnJ
SCANNED
BY
St. Lucie County
Planning &Development
Y - Building Permit Application Services
Planning,and Development Services NOV ]_ $ 2�19
Building and Code'Regulation Division
2300 Virginia Avenue, Fort Pierce F! 34992
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residentk
IC
PERMITTYPEs TnOb�ii �o
Address: 5039 AMY_ ✓L FORT PIERCE FL34946/
)ANE
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Property Tax iD #i: I� c� - _ o DO (D Q Vim) Lot No:
Site Plan Name: Block No.
Project Name:.
NINE✓Jti'
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Additional work to be performed under this,permit- check all that apply:
—Mechanical_ Gas Tank `Gas Piping — Shutters -Windows/Doors
'�-' Electric L Plumbing —Sprinklers _ Generator _ Roof- Pitch
Total Sq. Ft of Construction: Sq. Ft of First Floor
Cost of Construction:$_ 0 utiliti s• 5 we Se i Butl.
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Name. e.
Address d 2; ^ �_¢t Company: MS
City.qr - i g u cId le StateF L Address: "file
il,Ct{- State r
Zip Code: 33 n Fax: t� City'
5�I ' -7cl z Zip Code:-3 `f6 �� Fax:
Phone No. n2ILI
E-MaillA(WCU55CCtp1�f efi(�VCOryYMt F , Phone No L ' 5?7
Fill in fee simple Title Holder on next page ( if different E-Mail MV4 -at, el A a •Kai • !'ow J
from the Owner listed above) State or County Licensee /a
if valueof construction is $2500or more, a RECORDED Notice of Commencement is required. _
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: _Not
Applicable
MORTGAGE COMPANY:
_ Not icable
Name:
Name:
Address:
Address:
City:
_ State:
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE LDER: _
Not Applicable
BONDING CoMPA
_Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
1 certify that no work or installation has commenced prior to the issuance of a permit.
no
the permit holder to build the subject structure
and covenants that may restrict or prohibit such
!ed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs,.screen rooms and accessory uses to another non-residential use
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED SLN TIjF`OB SITE IJEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
as
OF
The.for i "instrpmen was. <nowWgeGbefforeme
this ayof 201b
STATE OFF DRIDA
COUNTY OF t;e�
The fo oing instrum t was acknowledged efore me
this iT day of �roti(g_. 20� by
� s uv\ of -Tin V /Yl
Name of persori making statement. Name
Known OR Produced Identification _ Persona
!ntification— Type of
Commission No.
REVIEWS
RECEIVED
PATRICIA ANN CN40ON
falYCj>�gj$SION g GG 361474
p I August1,=
SO; 1111I Treu NdWPubile Nndm uft,
FRONT ZONING SUPERVISOR I PLANS
COUNTER I REVIEW I REVIEW LREVIEW
arson making statement.
Known OR Produced Identification
Boa o a
z ei
m m
i
if Notary Public -rotate of Florida )
No. !)t�6(seal) ty
VEGETATION FSEATURiLE MANGROVE
REVIEWEVIEW REVIEW
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