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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q Date: Permit Number: Building Permit Application Planning and Development Services 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-ar.row.at the end of line PROPOSE IMPROVEMENT LOCATION Address: W©od c'fe-54- Legal Description: Property Tax ID#:. oZc3o8 –/f/' oao2--Ono' Lot No. Site Plan Name: Block,No. Project Name: Setbacks Front' " Back: Right Side- Left Side: DETAILED DESCRIPTION�OF WORK: _ A , eAl��� jOo �Selclice o /cam Age,-vic .off �/►C' 6YI��/ 4CONSTRU.CTION INFORMATION: dditional work to e e orme under this permit-check a appy: CIH AC 0 Gas Tank Gas Piping —Shutters ❑Windows/Doors - Electric ❑ Plumbing –]Sprinklers ❑Generator ❑ Roof Roof pitch g U p — Total Sq. Ft of Construction: S Ft.of First Floor: Cost of Construction:$ I�b� ac' Utilities: Sewer 0Septic Building Height: OWNER%LESSEE CONTRACTOR:`- ' Name' ,441ij Name: Address: . 31 W004c�j•' Or Company: I City: . ):;�• 1`1elrce, re--f/4 -State:,a Address: /IA-e AA n Zip Code: .3L/9�lSJ- Fax: City:; 4Qie►'i_& ��.� Stater Phone No. .7 2 _ �1 1 CDS Zip Code: q? Fax: T 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: rG 1-30016 Z2- if 2if value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION. _- DESIGN ER/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. 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 con-sideration`of the granting of this requested permit,I do hereby agree that 1 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'Commencen`ient-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 commencingwork or recordingour Notice-&Commencement: ; Signature o r/Lessee/Contractor as Agent for Owner Signatu e o Contr or/License Holder STATE OF FLORIDA STATE OF FLORIDA , COUNTY OFCOUNTY OF ..0�.:01� The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me - this_7 4' day of —&—e-e ,20iby this�(� day of '30 2: 201T by Name of person making s a ement Na„ e-pf,person m ing statement - Personally Known OR Produced Identification. Personally Krfown ✓ OR Produced Identification Type'of Identification Type of,Identification Produced Produced JOSEPHINEO F ,.1Pav a e JOSEPHINE 0.At F K (Signature of-Notary Public-State f r No Public-'Stat Si�ridd a of Notary Public-State r o ary u ic, tate of lorida =•. .•_ Commission#G 042322 - :N'. •P Commission#-GG 0 322 Commission No. 9-0�(a.3� "=,rF *�j My Comm.Expires 0 t�� on.No. G-&O4�3�. ';;o�� �a�y Comm.Expires,Oct: 2020 Bonded through Nations Notary Assn. onded through'National of y Assn. REVIEWS FRONT ZONING - SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW-_ 'REVIEW REVIEW REVIEW REVIEW . DATE RECEIVED DATE COMPLETED Rev.82/17