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HomeMy WebLinkAboutBuilding Permit Application (4) ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: RECEIVED ----� --- — ---- --- Building Permit Application JUN 0 81018 Planning and Development Services Permitting DepartmentSt. Lucie Coun 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: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENTLOCATION: Address: 71311 5CA0sc-T L'�)LVp Legal Description: 10 0 1 A�W RlVI=R J5-:GTA.`CF7 U0l4 9 151-L 158 (_g:)-'[' MA-2 ?A/I IN ol2 1951-547- Property 931-547- Property Tax ID#:___-34oZ -a®9 - o;ZrM --©cxD -7 Lot No. 1362 Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: 1u�zl�c�,� Su�,rrTrl✓R5 On W r n_b671X ` efl U/ CONSTRUCTION INFORMATION: Additional work toe e orme un er t is permit-check a y: HVAC Gas Tank ❑Gas PipingQ Shutters Windows/Doors 11 Electric 0 MGenerator Plumbing Sprinklers 1:1Roof Roof pitch Total Sq. Ft of Construction: SFt.of First Floor: Cost of Construction:$ Utilities:cnSewer Septic Building Height: OWN'ERAESSEE: CONTRACTOR: Name LPA L_A,ul_iP_ &PA\ Name: Address:_ g 5iij f9st4 EPJNf 1S 4t&p_F Company: City: :5 TaAa7l State: R- Address: Zip Code: Fax: City: State: Phone No. E7-&( — —2,09 - Zip Code: Fax: E-Mail: WcLa bQ==9 M-aiQ .C-4DN1 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, 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: / IJk4QIQ L6,d2l1r HA2 Name: Address:fit, fin! I-6Na12mms Wb}" r-AL Address: City: T City: Zip: 3 Phone: 56 1 - SI 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 inspec 'on. If you intend to obtain financing, consult with lender or an attorney before commencing work rAcording ypur Notice of Commencement. Signature of caner/Lessee/Contractor r Owner Signature of Contractor/License Holder STATE OF FLORIDA //�� STATE OF FLORIDA COUNTY OF �/"F1-C,✓h COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 74--day of J vna— 20/," by this day of 20_ by A-tAiJ 80A2- Name of person making statement Name of person making statement Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Notary Public gnature of Notary Public-State of Florida) �....... PAMELA ADAMS Commission No. :,:Coi),n#GG 000225 C mission No. (Seal) Expires July 7,2020 ••.;od:�Qp'' Bonded ThruTroyFain insurance BOD•3B 7019 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17