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HomeMy WebLinkAboutpermit application ALL APPLICA LE INTO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: � R3 C'(d 7 Permit Number: 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: To Select from dropbox, click arrow at the end of line PRO'P.OSfD IMPROVEMENT LOCATION Address: os La&o S Legal Description: 1�0 114 QT FR(2-T Q-F S EC n S S�I O W �1�1 ,-) 463 - 4-0 c J fl G- -L��Cq Lo S �6�s �(0 , I t� AQ �P 31�3�) Property Tax ID#:�..s �� � l�V — 0 405 000 Lot No. _ Site Plan Name: Block No. Project Name: W ot_ II e �-- h-p_ - r r-on .a eke M eu an iS Setbacks Front (0 Back: Right Side: O Left Side: © P , � (� _121VE'I'trA& DETAILED DESCRIPTION OF'WORK � rep 1aoem 0 yJ i� le-(,ecfn'c CONSTRUCTION,INFORMATION Additional work to fi orme un er t is permit—c ec a appy: HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors 11 Electric L_9 Plumbing Sprinklers 11 Generator E] Roof Roof pitch Total Sq. Ft of Construction: cS S . Ft.of First Floor: 3 ,t5 SF11-- Cost of Construction:$ '760, yo Utilities: _Sewer Septic Building Height: I s ) 01NNER/LESS EE: CONTRACTOR: Name S O Name: —J— S o rl 2 san, LOL I/ Addres :: I C� s Ll� Company: o r t-rs City: 1 b 4 J+. l,lL Q State:� Address: ��� � e Zip Code: Fax: A 1a City: fl t- `+1 _u �i�e Stater Phone No. � a — a4 9 — 4(O r7 Zip Code: 34q �7 J Fax: Irl a E-Mail: h 10, Phone No. -772-- (0 Zb — 1 S — Fill in fee simple Title Holder on next page(if different E-Mail: � , "e a0c)rV c, G1 cto L nrn from the Owner listed above) State or County•,License: 0-EC 142-2/12L If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL'CQNSTRIJCTION.,LIEN LAW INFORMA DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable Name: n A Name: 11 JA Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLF TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable Name: h GI Name: h In 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 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. Sigffdture of Owner/Lessee/Contractor as Agent for Owner Signatu of Contractor/License Holder STATE OF FLORIDA ) �iSTATE OF FLORIDA COUNTY OF 5 + [ s LL COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this Z L NC 20 Eby this 23 r- L 20 q—by �?"P°� OSsYPuyG RADAMEE ORLANDI RADAMEE ORLANDI WYS{ MYCO.'vil�-iISSION#FF229249 r MYCOMhUSSION#FF229249 (Name ¢ka�yy4 (Nam (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known_X OR Produced Identification Personally Known l— OR Produced Identification Type of Identification Produced Type of Identificatiio/onn' Produced Commission No. fiE ZZ ommission No. P `ten RADAMEE ORLAND .sem,*P° RADAMEE ORLAND riw6o MY COMMISSION#FF2M aid EXPIRES:May 11,2019Q EXPIRES:May 11,2019 Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATI,QN,: SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEVI/`_"`-'j't" REVIEW REVIEW DATE COMPLETE INITIALS