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HomeMy WebLinkAboutBuilding Permit ApplicationSUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATIONS DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY- _ Not Applicable Name: Address: Address may: State- Zip: Phone: City. State: Zip: Phone: FEE SIMPLE TIRE HOLDER: _ Not Applicable Name: BONDING COMPANY: Not Applicable Name: Address: Address: City: City: Zip: Phone: Zip: Phone - 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 Signature of Own J Agent) L ee STATE OF FLORIDA COUNTY OF a,�J Signature of Corrtractor7/Ucense Hold STATE OF FLORIDAv COUNTY OF Them oing instrument was acknowledged before me The fo ing in ument was acknowledged before me this day of ,lYq- . 20 W by _ this day of r 20 $ by (Name of person acknowledging) (Name of person acknowie ging) - (&-t,te 2.9fnWaZ---' (Signature of Nota ublic- State of Florida ) Personally Known _� OR Produced Identification Type of Ide eoinsri' CHRISTINE i 7GG Commissi -,2 , " Notary Public Orrm'" o� a 's'4 Mr CommExpires (Signature of Nn .Public- State of Florida V /) Personally Known OR Produced Identification Type of IdeaW&W We Notary Public • Stat (yrlda ommission x G 9 9 Ay Comm. Expires Aug 21, 202 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS ALL APPLICAB .E 1 IFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: "JI. 71z i�tUsh irr �vssi b lei .P no Building Permit Application c 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 arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: 3a��1J1:TfLlliil�r���i�1�11ty1��I�f3:3ifi�► i LegalD- : I �..� . � �1. � yr 1 Property Tax ID #: 34t"I' 'J III ' 0 o -L i ' ©0o, I Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: , bVt j j oMall r�ew RUO I�kI�o( W rrh -7, 5 Krol wxt CONSTPUCTIONINFORMATION: HVAC Gas Tank [ ❑ Gas Piping ❑ Shutters Windows/Doors 11 Electric 0 Plumbing OSprinklers 1:1 Generator E]Roof Total Sq. Ft of Construction: S Ft. of First Floor: Cost of Construction: $ 5000.60 Utilities: Sewer 0 Septic Building Height: _ OWNER/LESSEE: CONTRACTOR: Name it Name: MIII a Address:0_2JDi Ll (P- tMar 111 Company: I Ifl0 City: VJ�SeNl Y1 1 LIA Stater Zip Code: 33I`J /� F_ax: Phone No, (�0 l� �' Address: 66105 A City: � QY� State: Zip Code: 7Y trJ ( Fax:-1��-Lirt10 37 Phone No. "r1;-kt-Lk4I E -Mail: Fill in fee simple Title Holder on next page I if different from the Owner listed above) E -Mail: boviro' Ca. �6 00. no State or Codnty License: MmW � If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.