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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: R ( _ Permit Number: 1 ' Coll 2-.� RECEIVED Building Permit Application AUG 0 2 2018 Planning and Development Services S7, LUCIe County, Permitting Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 y Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line v--A PROPOSED;IMPROVEM ENTLOCATIQN „> Address: /v /-r 14 46 _ /'��' 3VIS Legal Description: PropertyTax ID##: © Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: ,,DETAILED DESCRIPTION OF WORK r , •IZe �� r z�� �IC-C x�0-- J1J CONSTRUCTION INFORMATION: Additional work to be nerformed under this permit—check all appy: I]HVAC Gas Tank [—]Gas Piping _Shutters a Windows/Doors 0Electric 0 Plumbing Sprinklers 1:1 Generator Roof Roof pitch Total Sq. Ft of Construction: Sq.Ft.of First Floor: Cost of Construction:$ BOO Utilities:0Sewer Septic Building Height: OWNER/LESSEE: - CONTRACTOR: NameName: Address: Company: ° / City: 1? State:. Address: rl,i [/— Zip Code: _ _ 3 •Fax: l - City: � S- �- State: Phone No. 7a-J d-06, (O Zip Code: 3 Fax: q E-Mail: Phone No. Fill in fee simple Title Holder on next page(if different E-Mail: 8•( from the Owner listed above) State or unty License: &=e-- �- If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. �SUPPLEMENTALLCONSTRUCTION LIEN . , DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE 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 thepermit holder to build the subject structure which is in conflict with any applicable Home Owners Association rules,bylaws or an 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 inspection. If you intend taobtain financing,consult with lender or an attorney before commencing work or recording.Vour Notice of Commencement. Signature of Own ss ctor as Agent for Owner Signature of Contra or r STATE OF FLORIDA ,¢ ,F I STATE OF FLORIDA o COUNTY OF ��C1 f✓ COUNTY OF � tJ The fo oing instrume was acknoyvledged fore me The forgoing instrume was ack�iowledged fore me this ay of c) Pl S 20�%y this day of G�`�� 20 by v ®-.��. B Name of pe aking statement Name of perso aking statement Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identificatio Type of Identification Produced Produced (Signature of Notary Pub S "'"'I�(orida) JOSE FRESNILLO (Si ature of Notary Pu is vE,Flo�ic�a Notary Public-State of FI rids ;rtr ti°Z o ary)Public-State of Florid 7—��-•� o mission#FF 1848 0 C misslon#FF 184850 Commission No.��t�/G. (S&g Co ission No. o;. �ry Sem!/Exaires Dec 22,20 8 My Comm.Expires Dec 22, 018 ,'''F°FF�O Bondedthrou xpires Dec Bonded through National Notary ssn. "'°"""� g Notary As 1 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE .RECEIVED DATE COMPLETED Rev.8/2/17