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HomeMy WebLinkAboutBuilding Permit Application F ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED t ,, Date: Permit Number: l.(� RECEIVED Building Permit Application JAN 12 2018 Planning and Development Services ST. Lucie County Pe ittln Building and Code Regulation Division _ g 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 Ele��Y�e� PROPOSED IMPROVEMENT LOCATION: Address: Legal Description: ql )+ o1I I 1Y nn N`e_C L( LU V 6ELq IQ 14- �T �� I[_1V qC Phom2Ual c 'l 17C- 6 L(; LgAq R_ Property Tax ID#: 19,0 -000j—CRUD - Lot No. Site Plan Name: - Block No. Project Name: (�t�l.. b /�In t ([ c(cf`f/ Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: CONSTRUCTION INFORMATION: Additional work to b rtormed under this permit—check a apply: ❑HVAC Gas Tank []Gas Piping Shutters a Windows/Doors Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch Total Sq. Ft of Construction: �yC1J S . Ft.of First Floor: Cost of Construction: $ (/� c� utilities:)Sewer Septic Building Height: O E LESSEE: CONTRACTOR: Name Lk n Name: 1AICALWtr Address: �� S �/� /t Company: ��l. ( oz� L �1, Cc SIL City: State: F1 Address: Zip Co C Fax: City: Ct c-- State: Phone No Zip Code: C(-' Fax: E-Mail: Phone No." 'P Fill in fee simple Title Holder on next page(if different E-Mail: V Loon n� n from the Owner listed above) State or Col ty License: , _©C)V_7 I c2 Cz If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. r SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION;_, 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. r nature of Owner/Lessee/Contractor as Agent for Owner Signature of Co actor License Ho er STATE OF FLORIDA - STATE OF FLORIDA tCOUNTY OF r-�ll n�� COUNTY OFnl1� �I The forgoing instrument was acknowledged before me Thgoing in nt was ack owledge fore me this g day of 201 by this`J day !. } 20Y Name of person making statement Naijrie of ptrs n making statement Personally Known OR Produced Identification Personally Known ✓ OR Produced Identification Type of Identification Type of Identificattn Produced 0 ?)CIU 1 LkIfA `e§qp � ��ji?l�'1-� Produced N (Si -re of No=-%"&_�taopt Notary Public,Slate o F1�BIgiaa ure of Notary P lic- to of FloridaCommissions FFCommission No. e IJAy comm. expires Ma.do;*M sion No. FR�*de c 4-%M J HEMORKS ., R. ,_ �••$x WY COMMISSION M GG 086596 MEXPIRES:July 22,2021 OF F�: REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17