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HomeMy WebLinkAboutbuilding permit ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 3 "3� p Permit Number: Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce Ft 34982 Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential �^ PEKMI I APPLIC:A I ION FOR: To Select from dropbox, click arrow at the end of line J PROPOSED IMNKOVEMEN I LOCAI ION: � Address: %,::VDs C " Al C%.rY'1 Legal Description: Property Tax ID#: 3333 - sa 1 OOZE 000 "S Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: Ut I AIL1=0 DESCKIP I ION OF WOKK: I �6/fe ley' �Ifi c �.1 /YS�P� �hAns� �r� /�/�y✓ CONSTRUCTION INFORMATION: I o a wor o e er rme`d under c is permit- eec a apply: 1VAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors Electric Plumbing Sprinklers FI Generator Roof Roof pitch Total Sq.Ft of Construction: Sq. Ft.of First Floor: Cost of Construction: $ Utilities:0Sewera Septic Building Height: OWNER/LESSEE:-.. CONTRACTOR: Name Ch ebcC& c Ar b 1 1I hCkL Name: C Uvco 7 l c,n 5 Address: Company; �u S TG n1 rs C'VNI; city: C ©y_1 State: 1Ly Address: Vr I 1 dg r ee r k ✓' Zip Code: L CO Fax: City: e5 P-T St. Luc r c_ State. r� Phone No. Sy 1 Jr�7�1 2 DO3 Zip Code: 3.+1752-- Fax: J 35-,c (- E-Mail: Phone No. I'11 3 3 5' - 313 )_ I Fill in fee simple Title Holder on next page(if different E-Mail: C u Stair S ti s 4 cx o(.(t,P71 from the Owner listed above) State or County License: C O 5 r i i If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEM EN I AL CONS 1 RUC i ION LIEN LAW I NFUttMA 1 ION: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: } City: State: City: State: Zip: Phone: Zip: Phone: i i I FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: rP• Phone: t I certifythat no work or installation has commenced prior to the issuance of a permit. St.Lucie Countv 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 1 will,in all respects,perform the work in accordance t ith the approved plans,the Florida Building Codes and St_Lucie County Amendments. The following building permit applications are exemptfrom undergoing a full concurrency review:room additions, accessory structures,swimming pools,fences,walls,signs, m 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 your Notice of Commencement. 5 I Signature of Owner/_essee/Contractor as Agent for Owner I Signature of Contractor/License Holder STATE OF FLORIDA ! (((( STATE OF FLORIDA COUNTY OF i�'C'.i COUNTY OF i i The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of c,_1 20 J&by this %0 day of_taC CVl.. 120 1 t by - _ t4 trl ironu I�,TI S (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Public-State of a) (Signature of Notary Public-State'of FI ' Personally Known OR Produced Identification Personally Known t� OR Produced Identification Type of identification Produced !J/j _ Type of Identification Produced Commission No_iT7 t3I(i�n(� Y q MOSTINEB n L d Il 1, ��`ry CHktrTii.� .r� 5 : . mission No_ c if '1 * { MYCOMMISSIM SGOSM Ylt Nam_ EXPIRES_Avd f2021 iltYt s > :ate•'- 3«rlg3 Revised 0:/15i2014 * * MYCOMMISSIOTNtGfiORM EVIRES:ApM4,2121 I � REVIEWS FRONT ZONING SUPERVISOR j PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW I REVIEW REVIEW REVIEW DATE COMPLETE f INITIALS 3 -- -- —.. --------— I --- j —