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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: II 1 Permit Number: !' '.I 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 PROPOSED IMPROVEMENT LOCATION.: f Address: 56-3© 9 iFo r-�'V- i 2�''c2� F- L 3 ;," 9 s tt nn �% 1 Legal Description: O l � a� U l l� 5 /D - PJ?a.s� 1 - Lo� 6S A.4 AP 1-311 ZS Property Tax I D #: 12 " S-00 ' © 0 0 - Lot No. 65 - Site 5 - Site Plan Name: J I e-r-rC5_ Block No. i Project Name: �. i e,� ✓�'. Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF' WORK: a.. CONSTRUCTION INFORMATION: Additional work toe e ec a orme . under this permit - c appy: HVAC f, Gas Tank ❑Gas Piping _ Shutters IlWindows/Doors Electric ❑ Plumbing OSprinklers Generator ERoof Roof pitch Total Sq. Ft of Construction: S. Ft. of First Floor: Cost of Construction: $ .3 , as3 0 oZi Utilities: Sewer []Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name -`So V1 S i Q V' f 011_ Name: Company: Address \ CA DVI-) @, _ .V' T rrN eAyie k 0 0 rV:',l 4 , Address: -e- "�:>f City: N �ev'C-e_ State: Zip Code: 3�i�� l Fax: Phone No. 0g -a�`7 y-- 3`7 0 fo City: Zip Code: Phone No. E -Mail: civ-hu\rr'% E- 2Y'C_-t? U State: L -540u-S- i iI Fax: 7-)-L—_7'V4-)_Y90 �-7 Z r 7 qq a is E -Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) State or County License: If value of construction is 52500 or more, a RECORDED Notice of Commencement is required. I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: I� DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: I .I FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: II City: City: Zip: Phone: ;I 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 covenant's 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 Amendme'I ts. 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 o% an attorney before commencina work or recordina vour Notice of Commencement. 11 Signature f Owner/Lessee/Contractor as Agent for Owner Signature oontractor/Licensd Holder STATE OF FLORIDA 1 STATE OF LORIDA COUNTY OF / ���- COUNTY OF The forgoing instr Tent a cknowledg d. efore me The for oing instru ent as a knowledged before me this l I day of 201y this day of 20 _JD6y L\vl:-vwy� �r NAIM, n'a� (Name of person acknowledging) (Name of person ackno le ging ) \ I (Signature of N ary Public- Stater of Florida ) (Sign ry Public- State of Florida ) �Idenn�tlficati�on OR Produced Identification Personally Known OR Produced Identification TProduced Type of Ide ific rndu' ed Fc �tptiV P�b,� A7bSt7a Commission No. PNGE0(sa of ftottda Commission;ftLd° .`�:- 1 11'StF1Commi„olaty # 0 P112 i:iV om es ssn. 07/I.O, MY r,0\1111 - Revised u9pat10nat�otaty P �<<aaw ;9csn % ' W10d REVIEWS JTRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS