HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE IN
Date:
'R APPLICATION TO BE ACCEPTED
,SCANNED Permit Number:
BY J;0fz a �UN& Ra 1+: I-7Iz -060 Aaunoz) alon7 'j5'
St. -Lucie --di1`.jr aw:Pedno5umiuuad
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Building Permit Application
Planning and Development Services C13A130—
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
BE COMPLETEI'
Commercial _ Residential, = `
PERMITTYPE:C1JGF (� A,N l.N)
Address: 3166 3w,,&StrJe,( a-`7 'S�rvn. far(- PQxcx 3yq yb
Property Tax ID #: LI l 2 9 , a 60_pL—�-7 Lot No.
Site Plan Name: Block No.
Project Name: Dc"lI`
DET 1LE DESCRIPTION
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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
Total Sq. Ft of Construction:
Cost of Construction: $ 9,000, cc
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i"J�sr 183 56+r'� z5 e
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Windows/Doors
Generator Roof ' Pitch
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
/83
OR M ERNTIMTE _
1 GONTRACTOK,
Name roX UP—
Name: to!I> U
Address: 0 (&w( is
Company, 6, p"
City: 'State-
Zip Code:
Phone N .
Ad(ress;+,17NC7p>c-
City: '*4 ►?•erce State: �G
Zip Code: T419!/ Fax: 772-�i- OLZL
Phone No 77t- 09 - M'7y
E-Mail: +2• L'/ i�
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail �l, r� yJo�l�n �at�oN¢ a1• CL
State or County License CFSG
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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.
DESIGNER/ENGINEER:
Name:
Address:
City:
Zip: Phon
FEE SIMPLE T TL OLE
Name:
AddrE
City: /ZCf2
Zip: Pon
State:
Applicable
MOJ
NamAddCityZipPhone:
BONDING COMPANY:
Address:
_Not Applicable
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 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 Contractor/ Ider
gnature of Lessee/Contractor as Agent for Owner
cen
STATE OF FLORIDA
COUNTY OF i
STATE OF FLORIDA
LC444?i
COUNTY OF 154
The for oing instrum}nt was acknowledged before me
�
The for oing instrumentwas acknowledged before me
�
this day of I�� • . 20 /g by
this day of F2 Q 26 9 by
Name of person making statement.
Name of person making state nt.
Personally Known I/ OR Produced Identification
Personally Known V/OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
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(Signature of Notary P
w i ' "
(Signature o
Commission No.
sr`DAVIDYOUNG..
Corn # FF236864
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Expires June 3, 2019n
is�•4•"'. ASHLEE PULCINI .. ' '. i
Notary Puhllc •State t P
Commission �• V $I .
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2e9179`,
,,.orN. My Comm. Expires fan 7, 202i
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