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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Yo 7 I / Date: •y ) Permit Number: / ME%vo CAY ED UN1M NJ E APR 18 2018 Building Permit Applicati rmitting Departmen Planning and Development Services St. Lucie Co. nty, FL Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: PROPOSED IN'PROUEMENT L®CATIQ' Address: Legal Description: �5-D GP 1104-. v`« (/"(;:I-� PropertyTax ID#: ZLZ--L, 3 (3 C O Lot No. Site Plan Name: 2' S-2 Vy'L y 11fi J &In Is Block No. Project Name: Setbacks Front Back: Right Side: Left Side: I=TAdPTIQN OF WORK; cS G;� CONSTRUCTl,®'N INF©�RMATI�N: Additional work to be performed under this permit-c ec a tat appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electric "'�l umbing —Sprinklers —Generator —Roof Pitch Total Sq. Ft of Construction:' Sq. Ft. of First Floor: Cost of Construction: $ 73 00 Utilities: —Sewer —Septic Building Height: QWNER/LE�S�SEE: CONTRACTOR: Name -�T 60.CC0 iM�I '{� _ Name: yc7 wl av V Q13� Address: _7L©� (� I�ln� 4r5 f v�G� �-� Company:' ompany: (���ro)�✓ Ip jc�YYi� �bj City: CL J State: Address: 6w_y),revL L4& Zip Code:j y`7 yk� Fax: City: State: Phone No._'?7 2 37 I f J Zip Code: y5 Fax: E-Mail: Phone No -7?2- T70 1(-S Fill in fee simple Title Holder on next page(.if different E-Mail ���"� �JYvi�tv7 ( Aollcom from the Owner listed above) State or County License ( 7S/S' If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SlJ�PPLEMENT L C®NSTRIJ�TION LIEN LAW I!N"E�RMATI ��N: DESIGNER/ENGINEER: _Not ApplicableMORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: _ State: City: State: Zip: Phone Zip: Phone: FEESIMPLE TITLEHOLDER: _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 pe tap icatio are exempt from undergoing a full concurrency review: room additions, accessory structures,s i min ool , ences,walls,signs,screen rooms and accessory uses to 4te esidential use WARNING TOO ER: our lure to Record a Notice of Commencement may r ying twice for improvements/our our ro y. A Notice of Commencement must be reco don the jobsite before the fir ' spe do . you intend to obtain financing, consult with derney.:hefgp commencin rk re rdin our Notice of Commencement. w�N Signatur a Lessee/Contractor as Agent for n� Signatur of o ac r icense Hole =o LU 9 mug.. se Cn ``� STATWF FLORIDA cog STAT F FLORIDA „L COUNTY OF �L` o° ° COUNTY OF a�w The fo ing instr ent was acknowledge fore m s�0C The forgoing instru ent wad acknowledge¢bef e " , a this day of 20 by W- this 7,day of 1LL� 20 by dN`?'Xc 6&)s of p c p V -/J --n-1U . .4y'o� 90n R" (Name of person acknowledging) -;�v,, i (Name of person acknowledging) (Signature of6/11ary Public-State of Florida ) (Signature of Nota ublic-State of Florida) Personally own OR Produced Identification Personally Known OR Produced Identification Type of Ide tiff ti n Type of Identificati n J/ Produced L' c Produced G� 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. 4