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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:_IW/L/L /83120/7 Permit Number: Building Permit Application RECRf r i r Planning and Development Services APR 18 Building and Code Regulation Division t 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 PROP©SfD IMPR'®vE�MENT LOCATION': Address: 4 Z g O Al f/1 ! -712— Legal Description: (?Cr941 /,1,0�17PA2 7-1 �3G�� /3 r/,vi7► 7/ Z /Iv�� �,v� r'A/tpA- V5r 40A-, r LL-iiiC'K-7-S C l2 27? - 71-17) Property Tax ID#: :l 2- 3 - S-01'- 67/Y B - OOH -�j Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: D'ETAPLED DE�S@RIPTION OF 1N®RK: ��i�lGGO /iE l�7 u� I-4-YG/f'GE .5 A-0 C4_"C--kz V if Z_ !v 7'w 4-,> T3�TN/Zo� S ANw`l Cf4_awd.e;r TEfE -,-yrxLvg* tg E AZ 7-e Aien.Si @®NaSTR+UCTtONI INf®RMAI OEMITO Additional work to be ertormed under this permit-check a ,[nappy: HVAC ,Gas Tank.. E]Gas Piping Shutters Q Windows/Doors Electric E Plumbin nnS rinklers Generator Roof Roof itch g U: p, .. ❑. P Total Sq. Ft of Construction: S '. fit:of First Floor: Cost of Construction:$ fid• Utilities: _Sewer Septic Building Height: EWL MR&_R, M5 59--1- W@®NTRACTOR: Name MAK A-.. F �/9,QLName: ;0 4-111-1>617z-_c, L L e_- Address: Address: ?!Z Z Ve7Z!94-4 VISr4 78 Company: 41- 3&x/-22 ,&((iNOZ City: (Z,+ty .f K State: TX Address: � '� IL-, Ca Zip Code: a, 27 4f!!! 3 Fax: City:.�l�G�r> ,l VCie�­ State:-F L_ Phone No. Zip Code: 3 4 f ac? � Fax: E-Mail: Phone No. 7 7Z 7 2-L( e?-/ ( 0 Fill in fee simple Title Holder on next page(if different E-Mail: (�pg7-1-C, '4- `o` from the Owner listed above) State or County License: GGG !4 z 8 z If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUP"ONNSSTALC©NSTRUCTION LI:RM LAW INF®RI�IATI®Nl: 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. Lucie County makes no representation that is granting a permit will authorize thepermit 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 reS;ording your Notice of Commencement. Y ~ ooz s Signature of Owne/Lessee/Contractor as Agent fo _ Sign are ontract r/License Holder —=� r,l STATE OF FLORIDA - ';;w STATE OF FLORID COUNTY OF COUNTY OF rn-c a X(->c o The for oing instru nt was acknowledged before a my m The forgoing instru nt was acknowledged before X� this day of 20 �7by "• � this day of 20 �7 by pr o •z fox z msm _ sem VL .A�®Y0 2S 2 .-1 •� �'�S C rnT T. W U.A I c �ZEEC (Name of person acknowledging) S_.�N (Name of person acknowledging) c A OIL �r N (Signature of N v y Public-Sta a of F orid ) (Signature of o ry Public-State of Flori a) Personally Known OR Pre4cqd Identification Personally Known 0 u ed Ide tification Type of Identification ProducedType of Identification Produced Commission No. (Seal) Commission No. (Seal) Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS