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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: _ v. '02 2 AUG 17 2017 BuildingPermit Application P"MITTING pp St. Lucie County, FL 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: PROEeIN01/EMENI" LO NyATIaN �� , o t . 'PRe B PaS Address: 1-1 1 r J"Tre_e r r Legal Description: o L� Property Tax ID#: 2�J O"a co C)3 C1 do l el 000 Lot No. Site Plan Name: Block No. Project Name: l Setbacks -.!Front Back: Right Side: Left Side: a-syY Y'I. DETA LED DESCRIPTION OF�WORK� e = t C� d °tea �. ( .x. �� ze .,ar 's P.w �. r �. � �',+ �,t per C_0 TRUCTION IN�F,OR�MA F�IQN u� � �#r ,, � � tar-,, ,x .t; :='s :.. _ a� � NO- 0i Additional work to be er orme un er 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: Cost of Construction: $ f' `O dp Utilities: _Sewer _Septic Building Height: OIIV,NER/LESSjEE� ; � CQNTRQ '` ' r *° �''s > .r�'3.^ �° .`a '`-+ `' ;ct's� � t ' �. aka Name 1-eAj e— FLE)t 0,,A i-�o L Q IfA +l (. Name: -1 Jpq t-I-)V- Address: " tfAddress: &'L r, l z,r- Lid Company: H Ce e.eii-r&A" City: f-I OV`h J -?L\.- V-- State:143 Address: t' ©�Ci S Li PA x191 L P Zip Code: v Fax: City: -s'��ri SA ,(�1 i I i f Stater Phone No. Zip Code: 3cg l-5a Fax: E-Mail: Phone No _511- 1{S'Z- e-'1-0A Fill in fee simple Title Holder on next page (if different E-Mail Z,5 +, nn m dil from the Owner listed above) State or County License LP-1-?n/K-j S"") 9 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SyIJPPL�11/IENTALCC}NSl'Rl1CTIDN IIN L.,4U1/ NFOR /IAT1'0`N: 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 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. Signa i r of Owner. L ee/Contractor as Agent for Owner Signature of Contractor ' ense Holder STATE OF FLORIDA,,, STATE OF FLORIDA COUNTY OF ®�, COUNTY OF 'S, The forgoing instr ent was acknowledged before me The forgoing ins ument was acknowledged before me thisLW day of 20n by this day.0 20ja by R"Wz � (Name of person acknowledging) (Name of person acknowledging) NIZD.aturrof Notary Public-Stat of Florida ) (Signat re of Notary Public-StA of Florida ) Personally Known OR Produced Id.entification'-�'"" Personally Known �QR Produdecf ldentificato'n Type of Identification LASHAHNA l�'"�"'" Type of Identification;2�`a`�nUAr Notary Public ,,, ,, 1 Produced o`PaY ruB� -- Notary Public State of Florida produced = ° ,a.1U My Comm.c:.pires pec?0.2010 y' 2010 .,=MY Comm.Expires Dec 20, ;�,\ a o . Commission lE FF 177249 ---iOF FvO ` N, Q ion #FF 177249 Bonded throw Nati al Notary Assn. Commission No. 4 -f °.' Co�S� l Commission No. - „o;,,,,•` Bo throw h National Notary Assn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 7/2014