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HomeMy WebLinkAboutBUILDING PERMIT �/,� // /4- co,(0,r" /- ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �17Y 16P Permit Number: ouliming rermix 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 [PhKM I I At PUCA i ION FOK: To Select from dropbox, dick arrow at the end of line PROPOSED IMPKOVEMEN I LOCAL ION: Address: Legal Description: Property Tax I S#: 33��- SD�' ©©�3 - D00-b Lot No. - I Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DE l AlaV 13E5CK1P-I IUN OF WOKK: /2,r 1.11rc T'� > e ll,'"3c- 0 ` K L � 7a iv i 5 SEE P__ �+ CONSTRUCTION 1NFORMAT101N: _ Additional workto e rm un er -c is permit ec a .app LTHVAC F]Gas Tank ElGas Piping _Shutters []Windows/Doors 11 Electric [ Plumbing 11Sprinklers 11 Generator FI Roof Roof pitch Total Sq. Ft of Construction: - -CO Sq. Ft.of First Floor. Cost of Construction: $ o Utilities:[]Sewer[]Septic Building Height: Oi1�tNER/LESSEE: 4CONTRACTOR: Nanie � hQrles Nt. N1eCuPn Name: Ct;+�TtS Si�rLIY►'�Cns Address: g o 4 4 h aid t mi o W Company t l s T�rvt �u s eyK S n:c, City: Pont S t l uc i e state: Fc- Address: 14�15 S 1f( I d4 .,- a r ee n p �o Tr 9t. C u c i State- Zip Code: J�'� 86 Fax: City. � Phone No. 215 - 3 a,T- `i 1� J . Zip Code: Fax `77J d 3 5-i 9 !c a E-Mail: Phone No. Fill in fee simple Title Holder on next page{if different E-Mail: u s t. t r- s ,l s -P Cr,0 C C vrn i r— from the Owner listed abode} State or County License: 519 10 - tf value of construction is$2500 or more,a RECORDED Notice of COnvnencerroent is required. SUPPLEMENIAL CONS I RUC IION LIEN LAW INFURMAIIUN: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: ; Name: Address: address: City: State: City: State: Zip: Phone: i2 Zip: Phone: i FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable Name: Name: I Address: Address: i City: City: I Zip: Phone: Zap: Phone: I certify that no,cork or installation �as commenced prior to the issuance of a permit. St-Lucie County makes no representation that is granting a pem?it%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 revie:v your deed for any restrictions which may apply. in consideration of the granting of this requested permit,I do hereby agree that 1:vill,in all respects,perform the work in accordance•r.,ith the approved plans,the Florida Building Codes and St-Lode County Amendments. The folicivAng building permit applications are exempt from undergoing a full concurency review:room additions, accessory structures,sLvimrning pools,fences,:walls,signs,screen rooms and accessory uses to another non-residentiai use WARN ING 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 your Notice of Commencement. Signature of oErner/�essee,'Contracior as Agent for O.:vner I Signature of Contractor/License Holder STATE OF FLORIDA ( STATE OF FLORIDA COUNTY OF < _ r' COUNTY OF r The forgoing instrument was acknowledged before me The forgoing instrument was acknov;ledged before n;e this_ day of A U V s t 20 l 8 by I this a 8 day of �v 20 l8 by i l ;Name of person acknowledging j ( (Name of person acknov:ledging) (Signature of Notary Public-State of Fonda) (Signature of Notary Public--State of=loria Personally K€ro:vn OR Produced identification Personally Kno.m OR Produced Identification i Type of Identification Produced i Type of Identification Produced Commission No. U7 �,1 N �f �^ Y° CHRISTINE13 W4thrnission No- L7 [ c�1 ct - Rr:? -'r 0525;6 �' 2q �' MYCOMMISSION3 FGV525d6 * ;* I )21 Nr c EJCPIRES_Apr� t -- 1tItY P 3MvFG3 zt o Bo AedTivu�xq=cr:a�ys.rvr� r .•• 7GLtSfi" —_ or Tb MY COMMISSiON f GG M2ak3 Revised 07/1-:201•f AFL- EXPIRES:AvrU1 a,2021 I REVIEWS FRONT ZONING SUPERVISOR I PLANS VEGETATION SEA TURTLE MANGROVE f COUNTER REVIEW REVIEW I REVIEW REVIEW REVIEW REVIEW I DATE COMPLETE INITIALS