HomeMy WebLinkAboutBuilding Permit Application -ALLAPPLICiABLE INFO MUST BE C®MPLETED'FOR APPLICATION To. BE ACCEPTED
Date: (P V� Permit Number:
• RECEi� rD JUN -24 n
Building Permit Applicata®n
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address: J S
Legal Description: Sl n �I)f)I(ax- Vi I IDIS LL7Yl�a
PropertyTax ID#: �j�J�a.— ��5" ����' 6d0 �� Lot No.
Site Plan Name: Block No.
Project Name: Swd cla-)(- Sbo r es
Setbacks Front Back: Right Side: Left Side:
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A itional work to be oertormed under this permit—check a t appy:
HVAC Gas Tank []Gas Piping FI Shutters Windows/Doors
FlElectric ❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 7q • 1.7 UtilitiesInSewer Septic Building Height:
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Name e-'± -t Htdinct k-Y)U Name:
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Address: y 10 5 . UekCI'n—D r- ` 0(0l Company.
City: aQhsQr 6aac-,41 State: FL Address
Zip Code: 3485 7 Fax: City: L State'
Phone No. (1 5!A) 9 A 3— 00 2y Zip Code: Fax
E-Mail: Phone No.
Fill in fee simple Title Holder on next page (if different E-Mai U�QaN`�
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applicable. MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. LucieCounty 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 jobsite
before the first inspection u intend to obtain financing, consult with lender or an attorney before
commencinor recordin our tice of Commencement.
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_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OFO ID STATE OF FLORID
COUNTY O�F COUNTYOF �C
TaeAcing instru ent was acknowledgebefore me The or o' g instru ent was acknowled d before me
day o 20Iay thio day of 20� by
(Name of person ac nowledging) (Name of'person acknowledging)
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(Signature of Notary Public-State of Florida ) Signature of Notary P)lic-State of Florida )
Personally Known,// OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. 0_�(Seal) Commission No
, +e�'• MELISA ARMENTO
;' gyp;•., MELISA ENiO �' - A.1Y COMMISSION#EE 855825
#sr0c)-_ EXPIRES:December 28,2
Hca EXPIRES:December 28,2118 c?r ......; bonded Thru Notary Public Undenvdters
Revised 07/15/2014 q Bonded Thru Notary Public Underwriters `�'' p�r1"'
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE b !t7
INITIALS