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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLEINFO `MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _ Date: Permit Number: , 7 0 OV RECEOVr "q mooffm Building Permit Application PEC / U(117 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: �= �j t �� �� wz � � x r �s�sv�wk,w rvsP, r-.s —:•s :' i '�� r Address: Qs1 a5 PDffi Scallllt .uCi -L 3S _- Legal Description: -m g!,rserve tit scua on Oub " bkV,So LSC 4�< (ac PropertyTax ID#: A4Qt,�--_l0W- ©013S"-®OO- '9 Lot No. 4q Site Plan Name: Block No. 50 Project Name: Setbacks Front Back: Right Side: Left Side: " C * -° ,I 'fix ata -'': �e: Mmom DEAhNLED ESRPO�NXv.K K m , ," 1w : . . teary xsi si:%nrArooq asci Xnsakal t r\ ik 0 uc ini" M, rot*. µ wli"101111wCO � KIN ' : ; ional work t0414:'e' pertorm,ecl under this permit-check all that appy: _Mechanical _Gas Tank- _Gas Piping _Shutters _Windows/Doors: _Electric _Plumbing _Sprinklers _Generator X Roof Total Sq."Ft of Construction: ��©�' Sq. Ft.of First Floor: Cost of Construction: $ bl 1 D-0 .0' Utilities: —Sewer —Septic Building Height: F�" OWNR/LESSEE '� y ICONI'R1`0 � , Wit , Vit.. iss s: Name MSeQh G J,5006I+iD Name:�cy,am W 1 {-c1C�, Address: MCrA4_wkGtv(_ In Company: A"CAQ A1CCfi(?C s 00 P City: PLT± SCi1r� Luca e_ State: FL Address: Qla(Oa SE L4.alacl�L,anl Ave Zip Code: `= A5a Fax: Ni A City: PL')Y-F Saint- Lucie State:-EL Phone No. 1.1;1- 813-3910 Zip Code: :,Ng5a. Fax: N E-Mail: N(Af Phone No Fill in fee simple Title Holder on next page (if different E-Mail r i1�e�w-hr�clnuK Ami t . c�c� from the Owner listed above) State or County License a l O`l If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL C*ONSTRUCTION LIEN LAW INFO'R.MATION: 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. , Signature of Owner/ essee/Contractor as Agent for Oter% "" Signature of Contractor/License Wolder , o .. STATE OF FLORID - r `' �� TATE OF FLO_ RIDA - �► �� COUNTY OF ?� OUNTY OF Z mem 112 The forgoing inst ment was acknowledged before me a for ing instrt was acknowledged befor !rn u en °L e3 �T its day of 20by this day of 20L7, by N�m m OQ �pZI W Ut. N Ti2�9 C (Name of person acknowledging) (Name of person acknowledging) •4;;,ild r -Public.State of Florida) (Signature of Nota ublic-State of Florida (Signature of Not ) Personally Known _OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 7/2014