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HomeMy WebLinkAboutBuilding Permit Application 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 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 OWNE •Your failure to Record a Notice of Commencement may res n y r paying twice for improvements to y r property. A Notice of Commencement must be reco d and sted on the jobsite before the first 'n =iou intend to obtain financing, consult wit nderor at rney before commencin k our Notice of Commencement. 1101 Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instru ent was acknowledged before me The fo going instru ent was acknowledged before me this day of 20� by this day of �� 20__by ey e ['— (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 7/2014 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED n {� Date: Permit Number: l 7pv RECEIVED Building Permit Application AUG 3 2011 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 x PERMIT APPLICATION FOR: RUV ):::7- &( LL Address: -o26?,14 AJ, ()L77 i)ly�e Uiuu Ir, Legal Description: Property Tax ID#:_ I LU9 701 W,01 /530 c Lot No. Site Plan Name: 6E7sc rX.-N L Block No. Project Name: 2- Setbacks Front Back: Right Side: Left Side: Additional work to-be—pertormed under this permit-check all tat appy: _Mechanical —Gas Tank _Gas Piping Shutters _Windows/Doors _Electric —Plumbing Sprinklers _Generator - Roof Pitch Total Sq. Ft of Construction: V _r Sq. Ft. of First Floor: Cost of Construction:$ 4 �x - ' Utilities: —Sewer —Septic Building Height: Name -T I. ©LMA a - tag Name: Address: 7c,201 N , (5 LT-> -1) ►.kle- t4 W Company: City: fit F It �.- State: Address: Zip Code: 3 4J 4(a Fax: City: ;5i- P Stater Phone No. _77`2, g©k ;5(Cj 2 Zip Code: --34ge2, Fax: 7,22- `go(-(d� E-Mail: Phone No -7-)2-- ZLb -ft'6V Fill in fee simple Title Holder on next page(if different E-Mail (, �, _ from the Owner listed above) State or County License' jCZ,,Cd"J'`?3/jp2 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.