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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED f tri / i<_ Date: `�� ' ) y Permit Number: ( Y v �O (Q ,J ComIN-Jrc. 1 F L O R I o i► ..r :_ Building Permit Application 1 Planning and Development Services MAR 22 20'18 Building and Code Regulation Division it 2300 Virginia Avenue,Fort Pierce FL 34982 / Phone: (772)462-1553 Fax: (772)462-1578 Commercial , Residential . 1/ PERMIT APPLICATION FOR: -� -,43-g i PRPC POSED IINPRT®VENT@'T LrOWATIrONo __...,.e„; . ,o ,00 i% Address: /0701 g £0 c-rth 0cecov � 13l't we 4t og U Te/-1 t ea -13�Ge eIz,I:1.3 4-937 Legal Description: V 7V2(.3C CSC-L se(.,-rzot4 a - L 0-C q/ (a i_ 2,crr'-H`-I 2?2 Property Tax ID#: 45? (- aO5- b oq l - 0 o6 - cp. Lot No. 9 ( Site Plan Name: / Block No. Project Name: ,V eta i"u r OL L l6e e e- Setbacks Front Back: Right Side: Left Side: AILED DESCRIPTIO .I]. p o a.. ,. .c:+11% rt}j';) ' Pd:-Ler ColvGRL %6: PA«o A s Tc9 t?L WS '(c-H(044 5 R rbar to1-9<< Com el t-e -19 8 PoLeRcD Plezced ai-el f eNi156�4:--( to c(( to t 50 e, PPS L' LL) F( 03 t 2 04 51---e. r c( `W 1 i?... -- .5‘ 4 G 6,,r TN 1 C ,- it tl a- CO STRUCTION,INF©RMATIO ]g .lr. e : ” brio' - &ft:ifigiro�; ' al- Additional "-Additional work to be performed. under this permit-check all that apply: _Mechanical Gas Tank " Gas Piping -. -'.'-Shutters . _Windows/Doors _Electric _Plumbing _Sprinklers _Generator Roof Pitch Total Sq. Ft of Construction: .*Fa Sq. Ft. of First Floor: Cost of Construction:$ E 075 a O C7 Utilities: —Sewer _Septic Building Height: OW,. ER/LE=SSEE? CONTRACTOR? . '':'; Name_t DAAZ 45E5u LEI-csv` Name: RE)et=1?(r/et C vcd0 ' Address:4481-,949i 361-1 •-rEK Company:13D8E12( fetc'c.=Q!'c(a I City:101-r LO tec(tfr14F State Address: (;7 3/3W, &45(eF? 1•-•e1/4eE Zip Code:Z.3/1 j 4b 7 Fax: City: Pip e--1- S I, L .e�� t State: (�Z.---' Phone No.cq,74) .3I7-L443 Zip Code: .3I-( .)�_' Fax: .77.2-34c' (ei'( E-Mail: Phone No 77 _a 41.0— (Lrg to Fill in fee simple Title Holder on next page(if different E-Mail Z L-(/_ a A l T, N 6-T' from the Owner listed above) State or County License a3 C)c5 )--- If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUP011MEN CONS RUCTJ®N MI , PMMATI®N . 4-. ,, -?„ a . , i 4 — rs•_. e, ..... a . ' .$.., . --, x 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 b- ••.. • • - commencing we rk or recording your Notice of Commencement. =. • //: / ZiZLII...(b— ,-,,, Signature o Ow er/Lessee/Contractor as Agen firiatui= ignature of Contractor/License Holder z o z_5 a . m_.. .p STATE OF FLORIDA =--M STATE OF FLORIDA - s��r COUNTY OF (4.-c &c it Z COUNTY OF .• EIA . Q�x 11 15 .� m The forgoing instrument was ack owledge ef..4n W m The f r wing instrument was acknowledge before,: °';`°`do. 4 this ay of R_( , 20 by this o -day of /7)0P-i-4� _ _,20)6 by +�':4i= (Name of person acknowledging) (Name of person acknowledging) OVIIIIIMb--41., (Signature of i•tary Public-State of Florida) (Signature o' 'otary Public-State of Flori a) Persona Known OR Produced Identification Personally ..own OR Produced IdentificatiorS --- Type of Idents ' t' nnn�� Type of Ide tiff :fen Produced ( r` �l L� Produced ) • eGy ' .,.�� C Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED 'ev. 7/2014