HomeMy WebLinkAboutBuilding Permit Application _ r
ALA.APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: tilt's Permit Number._n I ���3
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_ Building Permit Application M01 �w��"�{�'
Planning and Developn+en#Sen�ic� �'
Building and Code Regulabfori Division N O V 17 2011
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ZM Virginia Avenue,rort Pierre FL 34982
Phone:(772)46e-1553 Fax lm)462-B78 =Commercial . Resi ftAaj
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PERMIT APPUCATION FOR: To Select from dropbox, didc arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address- 13-7-3
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Legal Description-
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Property Tax ID#: X346- do o �OOwCatNo.
Ste Plan Name: _J_��r-r !/i f�5 7 L C CC-- w l!C Gc���9� Block No. aL
Project Name:
op Setbacks Front Back RightStde:' Left Side:
J-DErAI'LEDD8CRIPTION--O.F-W-.ORK:
At 7Vd-
CONSTRUCTION _ -
AdditionalworKtobenerformed under this permit ch all ap
i
HVAC O-GasTank ❑Gas Piping = _Shutters Q Windows/Doors
DElectric U Plumbing [:]Sprinklers UGenerator 13 Roof
Total Sq.Ft of Construction:/tSq.Ft.of r=ust Floor.
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Cost of Construction:$ warmest Usewer USeptic Building Height
OWNER/LESSEE: CONTRACTOR:
Name h 0 pq 4 G X, Name- Fa
Address: r- it _Companr. c •rk
citir ,State:2 Address t� :
Zip Code.- 3 `f%.--( Fax: /1��� City: F ' l iii State:—E
Phone No. �`-Sri`-' Zip Coder tff Fax. 7-2�•'" �� f
E-Maik Phone No.
Fill in flee Ample Tide Holder on next page(if ddferent E-Mail:
from the Owner Rsted above) State or Cou 'cense:
if value of amsaucdon is$2500 or more,a RECORDED Notice of required.
DESIGNER ENGINEER: Not Applicable MORTGAGE COMPANY: —Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TI i.E HOLDER: - _Not Applicable BONDING COMPANY: _Not Applicable
Name• Name•
Address: y Address:
Zip Phone: Tp 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 apermit 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 1 will,in all respects,perform the work
in accordance with the approved pians,the Florida Building Codes and St.Lucie County Amendments.
The foilowing building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screeivrooniVand accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your7oaying 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.
Signature of Owner/Agent/Lessee Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLO 1 A
COUNTY OF COUNTY OF
The forgoing instrgme�was acknowledged before me The forgoing Instrumentwas acknowledged before me
this 11 day of �WJ o .-20 by this 1. .day of N .20_* by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Pubk-State of Florida) (Signature of Nota ublic-State of Florida)
Personally Known OR Produced Identification Personally Known OR Pr duped id�eatiat�ion
Type of identification Produced -t- L Type of Identification_—rain¢ LL _ "r +
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Revised 07/15/20 6onded�hNt10 ` _
REVIEWS - FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
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