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HomeMy WebLinkAboutBuilding Permit Application 0(0(06 ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Wvn Permit Nu 1 unoo 5551-4s 4U@W4J2daQ 5Ui44iiJ@d e Building Permit Appl catin 8102 0 9 Nnr Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:(7,72)462-1553 Fax:(772)462-1578 Commercial JA W4 PERMIT APPLICATION FOR To Select from dropbox, click arrow at the end of line •:PROP,OSEDzIMPROVEIIAENT�LOCATION. _ Address: $77 Legal Description: L x V PH 3 Property Tax ID ll: 353y•502'�0�-Ooa- l - _- --- - - - - i_ Lot No.-WA-.. Site Plan Name: tI Block No. � Project Name: +- Setbacks Front Back: Right Side: eftSide: PA4-P-- _QETAIL'EDIDESCRIPTION'OF WURK• s_ { .i� r _ '9e>Mol;k4ow% rcwtov4 J 4,i iln4C%%*v' -P 4,c; 4vJ sc(e&f W's-A �,CONSTRUCTION�INFORMATION •• • = _ _ .'..i AClaitional work oe orme under is perm -checkaffapply: HVAC flasTank ❑Gas Piping Sh tters []Windows/Doors 11 Electric 0 Plumbing ❑Sprinklers Q Ge erator []Roof Roof pitch Total Sq.Ft of Construction: S .Ft.of Fitst Floor: Cast of Construction: �Dd.� . O $ ' %'lJtilities: Sew rSepti `' Building Height: i01NNER/LESSEE} , T - ' ON A tCTOR ' Name Irredin, S Name:` Address: 3405 C1"t, Fork. Ty, ► Company: City:F A W of �, - State:] Address: V - Zip Code::11v to Fax: 911—S44L-72.%1 City: State:_1-� Phone No. - 441 3 Zip Code: L"1 Fax:'172-7 1-85o5 E-Mail: S ei f fi%, . co_M Phone No "772.-781-_9!!9V0 Fill in fee simple Title Holder on next page(if different E-Mail: @ 4 Sclu from the Owner listed above) State or C unty License: G&C-OLIg793 If value of construction Is$2500 or more,a RECORDED Notice of Commencen ent is required. / /� f LN AL 0.NS_1,TAU! i:0N&V EN 1 L�W,4I DESIGNER ENGINEER:- Not A'plicable "'MORTGA E COMPANY: Not Applicable Name: &A G. ,r sg orj&jA Name:_ Address: V1 2 -S'6 A Address:, City:_ S4.0,WJ' State: FL. City: State: Zip: MA(v Phone_772.2,U - $,uT Zip: Phone: FEE SIMPLE TITLEHOLDER: Not Applicable BONDINGCOMPANY: , Not Applicable Name: Name: Address: Address: City: 1i City: Zip: Phone: Zip: Phone: OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain permit to do the work and installation as indicated. I certify that no work or installation has commenced prior to the Issuance of a F ermit. St.Lucie County makes no representation that is granting apermit will authoriz the permit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules,bylaws i ir and covenants that may restrict or prohibit such structure.Please consult with your Home Owners Association and review your c eed for any restrictions which may apply. In consideration 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 ounty Amendments. The Following building permit applications are exempt from undergoing a full co currency 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 Commence nent 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 su t_wltVRnder or an71- 'C Orne before commencingwork or recordingNotice of Commen ent Sig=TEOF Owner/Lessee/Contractor as Agent for Owner Sig ature o C ntractor/Li n Holder STLORIDA STATE OF ORiDA COUNTY OF � COUNTY OF The forming instrument was acknowledged before me The forgoiril instrument was acknowledged before me this 32:day of -Tu rL ,20 )5.by this11=1 da of w e_ .10 1.1 by G_Y, � © to,Vu Name of pe rso making statement Na a of person making statement Personally Known �/ OR Produced Identification Personally Known OR Produced identification Type of Identification Type of Ider tification Produced Produced CID_60_� 1 -11111'.- 6-ux-f, b (Signature(idf Nota (Signature f Notary Public-State of Florida I E. . , ..=c+ c�t� ��I C.State.'Of-Tex ��YPs LAURAJ.COLYIIELL Commission No. :9'•::..+.- Comm. S-02-16-2022 7. ������ 'COMMISSiON#FF9 90 (�� Commission No.FF 9990 �-... Notary ID 129708440 * EXPIRES-Apd6•202 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17