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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: IPLO) IS se ; ~ RECEIVED FEB 7 2012 Building Permit Application PEWAITTING Planning and Development Services St. Lucia 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: ww��� cQ � PRQPUSED INS 01iRMENT LO Address: S'(3 fJ Legal Description: o�' �:�a?5 5 /%,5e_ / Property Tax ID#: /3/3 -S 402- - ©033 - 000 -S Lot No. Site Plan Name: ywhif Block No: Project Name: J70ae Setbacks Front Back: Right Side: Left Side: D'E AILEDIff CR9P =- Wio, R . ,�/� i� �.,-,s ;� �. 4A mew l°�11_ Y;��,i �o .� c f (S er•/'esy� `lam // _ ` onnl,�-,2 I r$ tdJe A CQNSTRTION INFO -W, 0'N Additional work to be pertormed under this permit-check all tat appy: _Mechanical Gas Tank _Gas Piping _Shutters X Windows/Doors ' Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ ?496,0.,?496,0.,00 Utilities: —Sewer —Septic Building Height: 0 `_ /LE-SSS CON1'RACTO'R: Names rip Name: /. Address: . D eel- Ali,, r,'te Company: ,(�iah /e14 Goa/5 X City: /c�- /�°�'�a State: /t� Address: ��� � /��� ��'�',ke_ Zip Code: 3 L/7 S Fax: City: p`i`ee State: j4 Phone No.Vmk- i YG 3 oZ f?7 Zip Code: 31/,y,4/91 Fax: E-Mail: lr_r Phone No ll 7207- - ,97-M -/3 D 8r Fill in fee simple Title Holder on next page (if different E-Mail `ie,/Y e,IX v7 vim.Ix--0, Go% from the Owner listed above) State or County License G b" /3-d 92-2, If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SU!�P E 'ENTAL CONST.'.UC`f'ION LEEN �L,A1N IN:FCJR'MAl"LQ:N�: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: dloole Name: 190 Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable Name: liJOvtd Name: /aor1P 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 commencing work or recording our Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License H151der STATE OF FLORIDA STATE OF FLORIDA LJJClE COUNTY OF (t'(E, COUNTY OF The forgoing instru was acknowledged before me The forgoing instrum as acknowledged efore me this day of 20 by this day of 2011 by l (Nam of person acknowledging) (Name of person acknowledging) (Signature of otary Public-State of Florida) (Si ture o No ary Public-State of Florida) Personally Known OR Produced Identification w"" Personally Known OR Produced Identification Type of Identification Type of Identif&i ation Produced n uced �""" I REN S. NIELSEV �EN S. NIELSE Commission No. "aY ° 'IS � ar 9 emission x FF 115t 3Q0 mIS510n NO. �`�': commission N FF 115637 My Commission Zion Expi es I __� ` ne 201 8 My Commission Expire ll lll. ` ��llllll� REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.