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HomeMy WebLinkAboutBuilding Permit Application i ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �j31 b— /� Permit Number: C Building Permit Application z Planning and Development Services d ? � Building and Code Regulation Division �' •r 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 r : - lfiQ � lYfl � Jl`#i!lT R; 4li { tom £ Pmt Address: Z06 16 /)&Y- ettr Aree'r'y Legal Description: 5 Property TaxID#: Lot No. 2 Site Plan Name: Block No. � Project Name: Setbacks Front Back: Right Side: Left Side: 0111-_" ___,,_�����������_����..� ©« S'rhwS�+,v :s u ,,:, Ctt -TRUGT[.tN:tl�i• UR. ..fit ..l�i `+.�,.. r.yy� .�'� '+,€r. ar? t ° i"'' r� + 'g z„k' 3 _ �,'D r J1P, } 6ta; AdditionalworKtobenertormed Under triis permit—check all appy: HVAC Gas Tank E]Gas Piping _Shutters ❑Windows/Doors Electric 0 Plumbing Sprinklers Generator Roof Roof pitch Total Sq. Ft of Construction: SFt.of First Floor: Cost of Construction:$ 2/4/`ys Utilities:cn Sewer 0Septic Building Height: ! T., k�rol r S5. 2 "" nM2-'°zi C11JEt/l i*5SI 3IRITRICTC} x � z '9='.* o z. _ gaM4:.f,-4'xn.,M n%„ ,,.& A=k. ':fimfl a " 0111' ?,kT-�+ '.,.*,`v#,d* .k..+..wsu fi.~• 5,c;r"�'t.' Name CLr cll t'Gi Name: Den/7/if ,Af /),eiJ Address: 06(o D?-ev- AVS Company: /Ve-w City: i:,' f l�Tae State: — Address: ///yq 5w 6. ffa5CA J Zip Code: 34gt SI Fax: City: odrr7 G State: rG Phone No. T)2 - 3 2 1-8bo 19 Zip Code: 3'Y�7 9 a„ Fax: E-Mail: Phone No. 772- ZZa- 40 LY' Fill in fee simple Title Holder on next page(if different E-Mail:C 6 C 0 CS 7 3S from the Owner listed above) State or County License: C 0/5. 7.7 5 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. S ?Pi AMEN Ai:GUNTI � Of�L11 �RIA'C3a �, "RIF MY- . ., ,. . DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phor'e: 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 thepermit h''older 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 ur Notice of,Commencement. '1 1 Signature of Owner/Lessee on ra oras gent for Owner Signature of Contractor License Holder STAOUTE OF NTY OF FLORIDA STATE OF(S� �yb COUNTY OF FLORIDA !�� The f gging instru ent was acknowledged before me The forgoing instru ent was acknowledged before me thisU day of 20 by this day of wV 20 17 by Name of person making statement Name of person making statement Personally Known c1./ OR Produced Identification Personally Known ✓ ;OR Produced Identification Type of Identification Type of Identification Produced Produced 6LOL(� UC (Signa (Signat e' ary PftftA tZe�8l=TH KEEPS ;.: Comm �.c MY'[OMMISSIc�N#GGO ���1 Commis ib = MY COMWIiSSION -.'�•,. "- ruary 21.2021 ,wn,,• E::'•RES February 21,2021 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17 �I C� Ld '�,J J