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HomeMy WebLinkAboutBuilding Permit Application I " ;r I it ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:�� ( � Z.©1 Permit Number: I' 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 L,--' PERMIT APPLICATION FOR: P To Select from dro box, click arrow at the end of'line PROPOSED IMPROVEMENT LOCATION: i Address:_1 Z S S. oje,�k;n s d . F+ Pi e�Ye I`L 3 y 5N'1 i Legal Description: I If Property Tax ID#: 2 313 1 1 3 - poo 1 - 0Z O - 7 I I Lot No. I' Site Plan Name: !I Block No. Project Name: Setbacks Front Back: Right Side: Left Side: FDETAILED DESCRIPTION OF WORK: ! iJ 5+Z►� (I AC_'_J LJ rli�pcJS i�, LLe�G c�.5 i�� I IG CONSTRUCTION INFORMATION: ! �j Additional work to be nerformed under tispermit-checka that apply: LI E1HVAC Gas Tank ❑Gas Piping L"'I Shutters EW,indows/Doors Electric 0 Plumbing Sprinklers _Generator 17� Roof Roof pitch Total Sq. Ft of Construction: S . Ft.of First Floor: Cost of Construction:$ qQ 1'�. _e)n. Utilities:�Sewer Septic �', Building Height: 'i Il OWNER/LESSEE: CONTRACTOR: �I Name LiS4 T. iJaq,,4 Name: C14CLr(cs T G,., L-kkke, Tr. Address: 1215 5. Company:fpet�si'W► City: F+: ecce State:L Address:2tlo5o' N Zip Code: 345 41 Fax: City: 0&e_tcLw6.rc I state: FL Phone No. 712 -�i'�-2 lO t Zip Code: 3 LIq-42. 1; Fax: '66_3-763-53c)-, E-Mail: Phone No._7 l 2,- 3-76 4,16 Z 6 Fill in fee simple Title Holder on next page(if different E-Mail: Crack e r X' ( 06 60L from the Owner listed above) State or County Liciense:I`S1_C #25 3 to 6 I�, If value of construction is$2500 or more,a RECORDED Notice of Commencement is required:i I � j, SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: y Not Applicable Name: Name: Address: Address: City: State: City: State: zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable i Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone:; i 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 covenant's 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 inlaccordance 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 recordedi 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. A)l s Signature of Owner/Lessee ntr ctor as Agent for Owner Signature of Contrac r License Holder STATE OF FLORIDA � (( STATE OF FLORIDA COUNTY OF �%1 , LL)&, COUNTY OF The for The forgoing instru ent was.acknowledged before me this a2sy of I�Ou► 20 Lby this A day of DCc,N'ItaGi✓Y 20 t!S�by Lln oY lyes _'� -J,\e Key- j6z �' ��Y^It s :r, KAY✓I 1 . (Name of person acknowledging) (Name of person acknowledging) (Signature of Nar Public-State of Florida) / (Sig ature of ary Public-State of Florida) Personally Known OR Produced Identification V Personally Known OR Produced Identification Type of Identification Produced 'DQ.. L1 e4*16f_ Type of i •fir°�.� � - 7.. NANCY W.ARLEDGE W COMMISSION#GG 16076 Com i4J. `QCs. (S I) Commi EQn c`'. 16,20'S II) ;._ MY GUMM1551UN 160769 '+ Q= ' dsr;°r gp ilru t7otary Wblic Ur�den�iters EXPIRES:November 15,2021 N -Underwilers , Revised 07/15a0_14- REVIEWS 7/15 2014REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW' REVIEW DATE COMPLETE INITIALS ' I