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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 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 a posted on the jobsite i before the first ins ion. if you intend to obtain financing, consult with le r an attorney before commencing,*o0of rezerding your Notice of Commencement. Si nature Own—er7-re--ssee/Contractor as Agent for Signature o mrifFictmYtrcense er STATE OF FLORIDA A STATE OF FLORIDA COUNTY OF COUNTY OF 5A 41c't, end M ��P0 The f Ding instrun�"t was acknowledged before m F 5The f0W'oing instrum was acknowledged beforn qAM ; this 7day of I IriA 2611 by W 0= this - day of 20 17 by aleyr UYJ�To w 6-m n c�v (f ObAlf) N 6,P (Name of person acknowledging) (Name of person acknowledging) (Signature of Nota ublic-State of Florida (Signature of Notary c-State of 'oriaa Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced Commission No. (Seat) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED lev. All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �} Date: �` j 7 Permit Number: OT � - s Building Permit Application AUG 13 2017 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 Address: 920'3 1z,' VS U Legal Description: 2JA2 AQ J CL LjZ A,iL, ` Ad-- rSAjt:-!5_ Property Tax iD#: -2r�l D©q Z t . "2 Lot No. lam_ Site Plan Name: k56112y Block No. r Project Name: Setbacks Front Back: Right Side: Left Side: .cyl/I,C� ,t1,►,�� 7(L�Pc,kc. � � —s ©� 2 Additional work to-be pertormed under this permit-check all that appy: _,.Mechanical u Gas Tank _Gas Piping —Shutters �Windows/Doors —Electric Plumbing _Sprinklers _Generator Roof Pitch Total Sq.Ft of Construction: 1 3C10 - Sq. Ft.of First Floor: Cost of Construction:$— � Or'c' Utilities: —Sewer —Septic Building Height: l ame ,; tc�,a.r Name: ddress: �y'' uSN- Company:�,� ��r}ris�a = � ,►c City: Bkmg— Stater Address:3z rpt -uyJt d�� Zip Code::Sq -., Fax: City: r; Stater Phone No. }-12. 6 Tq 70°jS'- Zip Code: � Fax: 772- LI(©C`01 - E-Mail: Phone No -z.-- -2 Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License if value of construction is 2500 or more,a RECORDED Notice of Commencement is required.