HomeMy WebLinkAboutBuilding Permit Application All APPLICAB E INFr MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Z Permit Number:. o
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Building Permit Application JAN 31 2010
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: ,
PRaPOS' a IN°PRavEMENT I. ATItN k
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Address: S o 0(bL 00
Legal Description: �j¢/CF (,1/00/� ��}/L�G L/A/i 7--,6 6k yU lel/
Property Tax ID#: �114 ,2, 60 DOv/ Lot No. / 7
Site Plan Name: �(_c) FLk�J P, Block No.�(L
Project Name: SVP ri lr�I✓/-„ti
Setbacks Front Back: Right Side: Left Side:
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Ct3NSTRUCTION 1NF0RI'IATIQN
. Additional work to be performed under this permit-check al t appy,:
Mechanical —Gas Tank —Gas Piping Shutters _Windows/Doors
Electric —Plumbing —Sprinklers `.Generator _Roof Pitch
Total Sq. Ft of Construction, Sq. Ft:of'First Floor:
Cost of Construction: $ ] 0 0 Utilities: Sewer Septic Building Height:
OVt�NER/LESSNE.' v .
ti CONTRAGTQRJii44
Name J��i4N' F`ir/f Name: 1 Gv
Address: /0/ S o 6 L 6� Company: oL,p6,v PS 6c-
City: State: Address: op 'J-jV,0 A i o IL
Zip Code: 7V Fax: / City: C Stater
Phone No. %77- - z�i�3 lido Zip Code: g, ye/gy Fax:
E-Mail: Phone No 777 ybif
Fill in fee simple Title Holder on next page(if different E-Mail ✓ - b,4 it (r [,dJlf-k 1494,0Lai
from the Owner listed above) State or County License e- A(, %L S'31 9 d
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
-"7777 77
SUPPLEMENTAL.GONSTRUCTI�N LIEN CAW INFOFtMATI4N
/ PP MORTGAGE COMPANY: _Not Applicably;
DESIGNER ENGINEER: Not Applicable e
j 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 thepermit 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 toyouyproperty. A Notice of Commencement must be record and posted on the jobsite
before the first in
ion. If you intend to obtain financing, consult with le d r or an attorney before
commencing work/6,rrecordiogpur Notice of Commencement.
Signature of Owner/Less-ee"lif'odractor as Agen Signature o ontractor/License HoVer N
STATE OF FLORIDA JSTATE OF FLORIDA =�
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COUNTY OF S/ Gi� _R-C COUNTY OF STS UGC
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The forgoing instrument was acknowledged bef �;r The forgoing instrument was 'cknowledged befor r$ w g
this 9 day of 'V/3 d 20 by ¢mm g this-4 day of 20� by �X ia
M oa 9 ¢> w
aUX $ m
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(Name of person acknowledging (Name of person acknowledging) . `a=
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SignatureNotary Public-State of Fforida ) (Signature of o ry Public-State of Florida )
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
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