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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED =Date:�T�1 Permit Number:AIIIIIII ' RECEIVE D MAY 0 9 2017 Building Permit Application 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: �•,v �Jq PR;LO OSED INPR��� El�lf•NT LO'C' TfON`: Address: &/b1-/9 Cl�Gt'�/ r-a, . �iet'c,c� tel, y9SS of Legal Description: kPRR • D'�tL T C-,IJ -rn fie_ 0,1. Lc\V-,-;, C, .1 Rw,�A-6 Property Tax ID#: )IlC�y - �6 CgCSC�tn Lot No. Site Plan Name: -5 C\ Block No. Project Name: �il gr. Setbacks Front Back: Right Side: )5 t Left Side: 100%01DE OMM ' R O '` 0'R' : CVt q M-PAE)tr,e 2t K2[ , 3 3b&v-erpo LJr5(4e&Jd(U ?©rpt ®wt' SVG fgn 2-t Y2 i 3;0&0 Ps-,PFi bWrr�e�k Cir �e cry Garage Area CONSTR'lJ 'ON FNIFO lU1AT10'N: Witional work to be performed under this permit-check all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator —Roof Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: o� Cost of Construction: $ oZ SDy Utilities: —Sewer _Septic Building Height: 0 NE � s o / o . Narfie°'.�I rn? �f�J.�2r �� �s i ••,Name: '�.c��=: �,`1=� ��"c�.n'�s Address `/� ° ' 1 �i'S Company -o"Ore c . . .... Cit .. C4-�-r t .. res - ��r�� � Y,.. S ate �;da s: \ �� Zip Code: �'?jyq�a Fax:-'-' City: _ 2CG� State: — Phone No.^ Zip Code: 11L QQLLt Fax:71,) E-Mail: Phone NoZlQ •qN-:f X77% Fill in fee simple Title Holder on next page,(if different E-Mail from the Owner listed above) State or County License -NO.la`�'��'? l` if value of construction is 2500 or more;a RECORDED Notice of Commencement is required. S° 'PP,EMENTAL CONSTRtJC�TPON LIEN LAW IN�FORIVIATfON: 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: 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 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 oran attorney before commencing work or recording our Notice of Commencement. 1N vleo,% 10 P o, CJ A. c4j —�> Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDASTATE j6g- S+. LLC Q COUNTOY OFORI�-L Lvc COUNTY OF i� The for oing instrumen was acknowledged before me The forgoing instrument was acknowledged before me this day of �-� 207 by this -1 day of (��� I 2011 by J._or-; 0. L - G vKs Lor, (Name of person acknowledging) .(Name of person acknowledging) Ok D/LC—CL.L= k,-k©Ut (Signature of Notary Public-State of Florida) (Signature of NN tary�Public-State of Florida Personally Knowny OR Produced Identification Personally Known V OR Produced Identification Type of Identification a of Identification Produced KARYN G DRAW r uced t~ MY COMMISSION#FF1911558 0. Nv*-4 �G DRAWDY Commission No.FF l? a (SEX"S February 11,2 1690 mission Nor-G 1% MY I SION#FF198558 EXPIRES February 11,2019 14C NA REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.