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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: v v� ECEIVED N; j Building Permit Applica ion APR 112018 Planning and Development Services Permitting Department Building and Code Regulation Division St. Lucie County, FL 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: - PRCIPOSED INPtO1/EMEENT:LOCATIQI �� Address: / 7 /�c'th�rb�l Ove 9`957- Legal Description: Property Tax ID#: q6-0c?-001-4'a,07- OSo ` Z Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DEVILED DESCRIPT iOl � WORK a M eO -r4GVCS14 ©IJ ' dr!✓CWa FeAlce 1 o "t /IJST�i.fieA t ro' reoin L' L �VG y _ al h CO_ NSTRUCTlOIV INFORMATION �= s �..,s,..��. Additional work to be performed un er this permit-check al .t at 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:$ Utilities: —Sewer _Septic Building Height: OVIC�IER/LESSEE. CTRAC 'OR ONg . Name y Name. Address:/7 +Vcfhc<dh five- Company: City: -7-epfcN 16&4State: FL Address: Zip Code:3`�957_2zsG Fax: City: State: Phone No.- 2? Zip Code: Fax: E-Mail: �jcG•/raQ q/ery`��- '° G'or+� c.�,r�•Nc� Phone No Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. I SUPPLEMENTAL CQNSTRUCTI N LIEN LAW 1NF0RIVIATIQN 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. Signature of Owner/Lessee/Contract s gent f �'ne"1? Signature of Contractor/License Holder STATE OF FLORID' �r r ; '' STATE OF FLORIDA COUNTY OF o COUNTY OF M <a The forgoing instru nt was acknowledged before xg m The forgoing instrument was acknowledged before me this�day of 20 n Uy m this day of 20_ by � moz � z (Name of person acknowledging) `°N (Name of person acknowledging) (Signature o�ytary Public-State of Plorida) (Signature of Notary Public-State of Florida) Personally Kno n OR Produced Identification Personally Known OR Produced Identification Type of Identificatiori ( Type of Identification Produced Produced 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.