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HomeMy WebLinkAboutPERMIT APPLICATION - 855 SE AIROSO BOULEVARD - 10-20-2017ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ­' ". Date: �"� Permit Number: • ,1: 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: Address:�� �E a1+i�pi�C_ ,� 1� Legal Description: giER PARK ,— OI VI V G- BLK' 61 to IT P-) (HAP 341218 S Property Tax ID #: Site Plan Name: _ Project Name: A Setbacks Front Lot No. 6)_ Block No. 6— Back: Right Side: Left Side: I DETAILED DESCRIPTION OF WORK: N `'ICS _31 C (J_ _)C_Vk on d r —C `; SjCi i��►'Yl��� v � ` d. �..:r k lit c� lL:� i � -1`�` fi'LJ � t lac.' ��C.: 2.5 tons 14 trER �cKage unit w � i i 6 Kw cl e�`tri c heat .rte vesiden+'(d praerN. mitionai worK to pepej rtormed under this permit— check all ©HVAC Gas Tank []Gas Piping 11Electric❑ Plumbing Sprinklers CONTRACTOR: apply: Shutters a Windows/Doors Generator ❑ Roof _ ❑ Total Sq. Ft of Construction: I Cost of Construction: $ 35 Q(c3 SFt. of First Floor: _ Utilities: Sewer 0 Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Name: lh `C-OUnAi Address: ) `L' Company:: , c City: r ,xrl�i't (. �"�(-State: r _. Zip Code: Fax: Phone No � i"5® - _ 1 Address: IG24,e;w+ j��' City: t'lx"r63(W L� j�' Zip Code: =34qg Lt Fax: pp Phone No. State : E -Mail: 'v woope, qrnazt o 1 1J Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E -Mail: ii rn1afee at (,t State or County License: I!ACA C G_3 it value of construction is 52500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: FRONT DESIGNER/ENGINEER: Name: Not Applicable MORTGAGE COMPANY: Name: X_ Not Applicable Address: City: Zip: Phone: State: Address: COUNTER City: Zip: Phone: State: FEE SIMPLE TITLE HOLDER: Name: Address: X Not Applicable BONDING COMPANY: Name: Not Applicable Address: City: City: Zip: Phone: 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 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 vour Notice of Commencement. t I . _ Signature of Owner/ L ee Agent Signature of ContrzVtor/License Hol STATE OF FLORIDA STATE OF FLORIDA COUNTY OF GnA ��,("� COUNTY OF 53 Lodi -e_ The f r oing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of _0�,�(.h fy- , 20 _�by this ,Z day of QC10 b0W- , 20 � by (Name of person acknowledging) (Name of person acknowledgi g ) A4�� (Signature of Notary Pu ic- State of Florida) (Signature of Nota ic- State of Florida ) Personally Known OR Produced Identification Personally Known X OR Prod Type of Identification Produced Type of Identification Produced Commission No.GC7 131 V6 Revised 07/15/2014 ) MONICA MELGARKRAurCommissionNo. MY COMMISSION #GG13 2> Bonded through 1st State Insuran MO9151RAGAR KRACH MY COMMISSION #GG131286 Bonded through 1st State Insurance REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS