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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUSTBECOMPLETED FOR APPLICATION TO BE ACCEPTED -p Date. � �5 Permit Number: 0 oy,, 0 -37 0 RECEIVAKE ECa� a VE - Building Permit Applicati n AP 11 Planning and Development Services 2018 Building and Code Regulation Division Permitting �epartmen 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Resi .1 Lucie Countyr FL PERMIT APPLICATION FOR: (,(J -e hoc,-���•- P oPOSED I`Nf�RbV ME LfJCAT,ION x \ Address: S � S TU Legal Description: Property Tax ID#: c2 _ Lot No. Site Plan Name: 00) h Block No. Project Name: Setbacks Front Back: Right Side: Left Side: tE1LFGS�CFIPT1QtF WRt ~ .,, C 0 A H CAT e FUf— .. . Lo Cry 1IoN5 CONSTRUCTIO{� NI=C►RMATIC}N i � I Additional work to be performed unclertnis permit-check a:ll t at:app y: _Mechanical Gas Tank —Gas Piping Shutters _Window's/Doors ' _Electric XPlumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor:. Cost of Construction:•$ 2 ©� r Utilities: _Sewer _Septic Building Height: 01IFIRjLESSE. kg 4NTRAGTaR. � .� . a. .... E ., .. Name CHXl S C CA 2v I r Name: Address: I DS S 1>S ,, S`t Company: City: •-D iz t State:, L Address: Zip Code: 3 4 Fax: q City: State: Phone No. 722 3 2 $ / Zip Code: Fax: E-Mail: 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. SE�F�EMEN, C NSTRUCTi�N IEI1�LA 1! t RItIIA�["[£ ' DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: _.. _-._.. _-._. -.- Name: ,Address:., - Address: Clty: State: City: State: Zip: Phone i Zip: Phone: FEE 51MPLE­TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable y Name: Name: Address: Address: .City: Zi 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/Contractor as Agent for vVrit;,•'` Signature of Contractor/License Holder is STATE OF FLORIDA ��j x STATE OF FLORIDA COUNTY OF LV �( C 2!9 o COUNTY OF W=� The forgoing instrumentwas acknowledged before ig a 2x The forgoing instrument was acknowledged before me this y of� a( L 20U by --T E this day of 20_ by C OfT W OA LEN ) 6 (Name of person acknowle (Name of person acknowledging) (Signature rotary Public-State f Florid ) / (Signature of Notary Public-Sate of Florida ) Personally n OR Produced Identification` Personally Known OR Produced Identification Type of Identifica 'on /� Type of Identification Produced �/ 'A�t��, Produced Commission Nor-) (Seal) Commission No., (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE. MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Tev.7/2014