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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED °� , r-)50/� Date: a, - Permit Number: !Yl 0.- ©r-)50 RECEWED FEB a 7 2017 _10 " _._.,w..�_ Building Permit Application Pc3tn fNG Planning and Development Services St. Lucie County, FL 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: PRt�-POS°EaD 1' "PRQ1/EME�NT L��C�ATIO'N: Address: ��U 6'0-0"605 ZZOAp ; ;Z:�Z &JC L. 5S Legal Description: f�¢!�Uoola ,� /� -UN �2- .�Lk ((p L-011— C-M A-P t3 C ole P-( !:2!2 - I Z3 Property Tax ID#: f 6 I - 002— -O l coc Lot No. L5 Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: " =REOTIMIE, DS;GRIP I,0'N-0' OR A. ,q-S f�ff/�-�T' Slf��✓C�L,� /�a� �l/��G�Edi C0N5 TR�, Sun UCTIO'. INFORM' 1'LON: Additional work to be performed under this permit—c ec a tat appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator I Roof /Z— Pitch Total Sq. Ft of Construction: t2_1 6106 Sq. Ft.of First Floor: Cost of Construction: $ c9-, 75�V Utilities: _Sewer Septic Building Height: OWN'ER�E�SSEE: � CO �'R"ACTO'R: Name Name: Address: 7D Company: City: Stater Address: Zip Code: Jr. Fax: City: State: Phone No. -7-7Z - 2/4 /3 2 Zip Code: Fax: E-Mail: J�C'o ,,1 3`a Phone 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. SUPPLEMENTAL CONSTRU' TION LIEN LAW UNF®RMATtON: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: 11-1 FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _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. 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 jobsite before the first inspection. If you intend to obtain financing, consult with lender.or an attorney before commenc'n w r recording our Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORID STATE OF FLORIDA COUNTY OF �,IJ UE, COUNTY OF The forgoing instrumentwas acknowledged before me The forgoing instrument was acknowledged before me this 4 day of 20X by this day of 20_ by (Name o person acknowledging) (Name of person acknowledging) A (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification jdentification Produced ��111111j�. KAREN S. NIE 156371 2 VB(C i _ Commission# FF Commission No. -s ` ) My Commission on No. (Seal) June 12, 2 ��FIIIII�� REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Te—v—.772014