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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: M o7 o n i Building Per it 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: PROPOSED IN.' ' O�fEMENT LOCATION. Address: D �� LV 6,6 Legal Description: Property Tax,ID#: 3 L1 114 - X10 - O _ Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DET PLED D 5CR'PT1)9 NOF WOR K1. PUr -&!is rr - - i s66ti- C© ISTR+UCTIJNf-OgKOWNTIONNS : iti nal work to be pertormed under this permit-check all that apply: _Mechanical Gas Tank. Gas Piping Shutters _Windows/Doors —Electric —Plumbing —Sprinklers Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ Utilities: —S wer _Septic Building Height: 01NER/LE=�SSEE: CdN RAC." tJR; Name' L1.f�-6 STMQAC,' 2:9 Name: -PA- .G GCs 9 T79 Address:.6W6 Milli JJ 9 Compa y:_ ,(l(�o PH II, City: `(?,() aftCA3 State: AddreWT:e� e�q. Zip Code: ( L4ft-L . I Fax: City: 1-1 REtLCg State:JL, Phone No. �z 331 C Zip Cod : 33�� Fax: E-Mail: Phoneo .M I - 3 AA- �3 'DO Fill in fee simple Title Holder_on next page'(if different E-Mail �Qt&-eo wu�-�� 3co vow, - C�0M- from the Owner listed above) State or County License _InAcl If value of construction is 2500 or more,a RECORDED Notice of Commenc ment is required. Sl1PPLEMENTAL CONSTRUCTION LIN 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: 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 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 inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording our Notice of Commencement. IC60 Signature of ssee/Contractor as Agent for OwnerSi nature o Co actor/License Holder COUNTY OF STATE OFIDA 1 OF COUNTY OFORIDA� c The forgoing instr ent was acknowledged before me The forgoing instr ment was acknowledged before me this day of 201-L.by this 11 day of 20 1$ by IL o � � 0 (Name of person acknowledging) (Name of person acknowledging) J�h6atlref Notary Public-State of Florida ) (Signature of Notary Public-Aate of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identificat* mon ._ Type of Iden' Produced ! .';;;:'ri'' IP`'"'ii;tiAIN6RAM Produced a�Pa°"¢''s L'... ..,"._ ';3RAM�__ii. Notary.Putiiic-State of Florida ?,* , Notary PubNc.Stafe of Fl q ida r Commission No. °_My Comm. E(Seal))ec 20,2016 Commission 9` hey Coma,.Expires Depeja,1j016 o. Commission #FF 177249 ''i�FFlO���' ommission #FF 177249 """"� Bondedthrou Bonded through National Notary Accn gh Nationai Alma „A- REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 7/2014