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HomeMy WebLinkAboutBuilding Permit Application I All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I �J} Date: Permit Number:_ Cir.E6 ..>.,.>s .. s -k Cel a APR 1®1J 2018 18 itiiiiViiiinnAliiM e '/tBldg Permit Application and Development Services ow_ : Building and Code Regulation Division � 2300 Virginia Avenue,Fort Pierce FL 34982 V Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential I PERMIT APPLICATION FOR: 1 • PROPOSED INPROVEMENT LOCATION. Address: CD .� po.1 dYt9&•r pls.YK v,/o,71 A- ,p ,vi,s 13 1-4,p1ea-ce_ SLI-?sr Legal Description: 1.30 I " (p 15 • 0 13.` ccDO3 ' Property Tax ID#: Lot No. 1 Site Plan Name: Block No. Project Name: II Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK E A-1 thcai9e. bGe'f . --. - -rod w l±It r7 ,5' f<.‘,11, N"et,' preyno•Tof Com ca--e Po.o4 CONSTRUCTION INFORMATION Additional work to be performed under this permit-check all that apply: -J 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:$ >-,S" "— Utilities: Sewer _Septic Building Height: — OWNER/LESSEE: : <3 CONTRACTOR: Name CSG //7VQ f Whits pre)pe ±7' )4-Cr Name:_LC-"t1/0 "/U I ytl II Address: POD r S .E., /111 U ti'ere' Rel Company: 6.r Coan 'r- M- .t'h G City: S+uo..r1- State: 1:--1._1:--1._ Address: -o (T,%Af. L-25\10 `/' 6--1\r r1 Zip Code: 9 t+'3 ei Fax: City: P . -5 . 1--- State: "F-(--- Phone FLPhone No. 17 7 (r- 3 ) >-7 Zip Code: °1+-41g'^S Fax: E-Mail: Phone No X77 -- ,5---1--r •—`]63 ci Fill in fee simple Title Holder on next page(if different E-Mail ,-t`r`j Qu/GI Couw?T-y' A it o) Gaon c).iI,Cbr'I from the Owner listed above) State or County License -P C t 8 r '7 2 3:I If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION 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 t• your property. A Notice of Commencement must be recorded and posted on the jobsite before the firs n.pection. If you intend to obtain financing, consult with le ser or an attorney before commencing , o k or recording your Notice of Commencement. .i , _i Signatu e of Owner Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF SI •L—Lc- C_, COUNTY OF S4-- l c The forgoing instrume t was acknowledged before me The forgoing instrument was acknowledged before me this )D day of � ,201a. by this I© day of -Ala I cl , 201k by ( lime of person ackno ledging) (Na of person acknowledging) i /MIL CA,k___ ,IL6 N._ AA A / A' .' '4 igna nrre of Notary Public-State of Florida) gnat a of Notary Public-State of lorida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced Commi ior1J (S4,,,, LA:HAHN.4INGRA(,Seal) Commission No. (Seal) ii P r ;_°;�`�: Notaryi uo;ic-State of Flo J r!' *•4 My Comm.Fxoires Dec 20,20i,, (- :Ni* 4 :34... e� T� �.�.,�,i°. LHb11HnNH IN�AM svf7�°� Commis.; ri FF 177249 a REVIEWS FRONT throng.i,_ UPERVISOR PLANS VEGTATf• _ MS1 A�TURTLEi ee o1),f,131,1^ OVE `COUNTER REVI REVIEW REVIEW REVS . YE�YLE 11! 1+ - °• n Tula.lun,ir,= FF 177c•en DATE . 111 °�F``'' '% Bonded Through Nation! votary Assn. RECEIVED DATE COMPLETED rev. 7/2014