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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 5 30 Permit Number: $0 RECEIVED Building Permit Application MAY 3 0 2018 Planning and Development Services ST. Lucie County, Building and Code Regulation DivisionPermitting 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential _ PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: _ Address: 13 L I E-0 `C6IU &AmtC � %'rt. ►�i L I'f C1: 3`�` h �— Legal Description: PALM a"VL :51D b' Lk L0_1_ 1000, 11 Property Tax ID#: ) J10 - 6o3 - N41) — 0 E0— 0 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION.OF WORK: �l�tn-12l CSN rAA5re1_ VU'DeL 8 )-q 5TI�C(, 61►ter 4E WOE W Ifih +So J-(op Ps ANT) ALL SND/t�.1� TgAULS A-VP 49N"WhIe CONSTRUCTION INFORMATION: Additional work to be performed under t ispermit—check all appy: HVAC Gas Tank Gas Piping _Shutters Windows/Doors Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch Total Sq. Ft of Construction: S Ft.of First Floor: p 0�' Cost of Construction:$ ! �, f Utilities: Sewer E]Septic Building Height: OWNER/LESSEE: , Name , ,�;� , i r� , �_ �- Name: V J Address: 4 3J 1:UKFegii4N Company: M S NAJ:D 1� ok ©1-71YC 7, City: �" , felt=k Ce State:_Jf"LJ Address: 912 .5, e=ll( 65 HLVJ Zip Code: `{��L Fax: City: Pr, PIC- ke,! State: Phone No. Ij x_ q ' a� Zip Code: 3 y 9 LI 5 Fax: -I-7 a- 5 a' `li 3 E-Mail: Phone No. � 9 Q <0 I Fill in fee simple Title Holder on next page( if different E-Mail: Je )Il AflOr5QM More 1—c f a '1 from the Owner listed above) State or County License: CR.C, 13 -3 15-YO If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. a •� mss.�q � '4'u;R'., _ "�' rr ».a_ s to ys �, � d '`^� ''' ., �.�..€. .`$€z 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 thepermit 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 th first inspection. If you intend to obtain financing, consult with lender or an attorney before commencirt work or recordin our Notice of Commencement. i I Signature o 0 er/Lessee/Contractor as Agent for Owner Signature o o tractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF S�r. COUNTY OF 'S� . Lye.%-P, The forgoing instrument was acknowledged before me The for oing instrument was acknowledged before me this3'b dayof VV-!1!h20\ by this dayof Mqy 20�by Name of person making statement Name of person making statement Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identific ion Type of Identification Produced L Produced (Signature of Notary Pu IIc State of Florida ..�wwwr. , (Signature of Notary P fit S��f=�eYi� .y D'::ANNA MARIE GIVENS ARIE GIVENS Commission No. T �W-44- _" 022029 �1re t; MYCP�ION#GG 02.2021 MYG ION#GG Commission No. FxPIRcS:Dcoember 16.2020 EXP rxmber'6 202 ;oneublla Underv+n ,t I s I Bonded ihru Notary Pubi c U,ue wu o'r Bordec 7 v„Notary• - -- REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17