HomeMy WebLinkAboutBuilding Permit Application (2) ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number!:
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Building Permit Applicatiln I
Planning and Development Services
Building and Code Regulation Division i
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial II Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Property Tax!D#: q J' -)Of 0 it(�"� (�� t' ' � �� I Lot No.�__—
Site Plan Name: Block No. _
Project Name:_SbccC' ��,:
Setbacks Front Back: Right Side: Left 5lde:1 1
itiona wor to e e orme un ert ispermrt-c ec a xappy. y1 !
Gas Tank Gas Pi in Shutters I WWiniiows/Doors
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Electric Plumbing �jSprinklers Generator I' +Roof
Total Sq.Ft of Construction: So.
Ft.of First Floor: ! i J
Cost of Construction:$ _�b 4t11, Utilitles,L3 Sewer!",.!Septic Building Height: --
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Name L�� Ec-. tt>� Name:=;�yatYlr
ddress:V ig
?Q/ A.) �jig 2± N Company:��•l- n � �=
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.City: Bose'&nsc"n is( eer,d State: Address: 1'2��
fit,. ' .�-1 ,C : Stater-
Zip Code: 3'19 Fax: City:
Phone No. '7)0'4- 4950-q 7 e-),? Zip code: Fax:.
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E-Mail: Phone No. �
Fill in fee simple Title holder on next page(if different E-Mail:
from the Owner listed above) State or County License: L ��
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If value of construction is$2500 or more,a RECORDED Notice of Commencement is requi e,ed.
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: j Not Applicable
Name: Name:
Address: Address: i 1
City: State: City: I State:
Zip: Phone: Zip: 1 Phone: ;
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FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: i _Not Applicable
Name: Name: I
Address: Address: I 1
City: City:
Zip: Phone: Zip: phone:l'
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i I certify thatno 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#hich 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-Fiarida Building Codes and St.Lucie County Amendments. 1
The fallowing 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-residentiai 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 th0obsite
before the first inspection. If you intend to obtain financing, consult with tender or an attorney before
commencing work or recording our Notice of Commencement.
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_Signature of Owner/Lessee/A t n re o ontractor/License Holder
STATE OF FLORIDA STATE OF FLORI
COUNTY OF I n CA COUNTY
The for aing instrument was acknowledged before me The fing Instrument was ai knowledged before me
this day of 20(Mby thisday of 17P�- i 20 / by
(Name of person acknowledging (Name o€person ac nowledgirg)
FUQ�i ANGELAYOUNG
* MY GOMMISS!'ON#FF 951069
EXPIRES:, i2,2Gi0
�. (S'ignat of Not Public- ate 6f l8rI aindedthruNd7getNe+arybCr1 S
(Signature ofibotary Pubilc-Sstate of Florida) i
Personal Known ►/i OR Produced Identification
Personally Known OR Produced identification Y I
T e of Identification Produced.
Type of Identification Produced � yp
Commission No.Golaci as(P 15e I L.. Commission No. I (Seal)
NICOLE SMITH
Commissio,=GG 12G2Se I
Revised 07/1512014 = � My Comm.Exoi,,', �29.2G21
'`�`aF Borded'll' "h luticral t,c ry»syr.
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW j REVIEW REVIEW
DATE !
COMPLETE I
INITIALS
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