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HomeMy WebLinkAboutBuilding Permit Application Sep 04 2018 1:01PM HP Fax page 2 ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: I I RECEIVED Building Per. it Application SEP 0 5 2018 Planning and i evelopmentServices ST. Lucie County, Permi ng Building and C de Regulation Division 2300 Virginia venue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential PERMIT AP LICATION FOR: To Select from drobox, click arrow at the end of line k. Address: 3 bhMAt, fl T� z ch Legal Description: Nt ¢'S ` kwn lAc, ACuti n` c ` tl !' ce.1 33 n,hP - 'w S (p c co nnr-bs. fl lQ O Y 366 =1 b5 Property Tax l M. ' 1 Sri- lo1'L-o9,n Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side Left Side: n C4'I w IA4tA M Ell I�V ' it nal wo k.to ElGasTank orme un ert is permit-c e a appy: HVAC aGas Piping _Shutters n Windows/Doors Electric Plumbing FISprinklers Generator Roof F77 Roof pitch Total Sq.Ft of onstruction: i o a o Sq.Ft.of First Floor: n:$� Cost of Constr tioco Utiliti s:OSewer ElSeptic . Building Height; Rr - Name AkM,L G Mur-,11 MLnn.j Address: `336 VtM s $1VD Company:-Air ca„"al A(,drReiatseYn};or, LL( -- City: ease Gh State:IL Address: SN t5 x v-&- onk or, Zip Code: V-0 51 Fax: City: State:I?`II__ Phone No. Zip Code:_3 LkOcr&2 Fax: �1`L-U►6 G b�3 E-Mail: Phone No._11"I L\ 64d-1-16 -- Fill in fee simple Title Holder on next page(if different E-Mail: from the Owne r listed above) State or County License: c XQ\$1 So 1g If value of const Liction is$2500 or more,a RECORDED Notice of Commencement is required. Sep 04 2018 1:01PM HP Fax page 3 DESIGNER/ NGINEER: Not Applicable (MORTGAGE COMPANY:' Not Applicable Name: Name- Address: Address: 'City: State: City State: Zip: Phone Zip: Phone: EEE SIMPLE TITLE HOLDER: Not Applicable _BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/COF TRACTOR AFFIDVIT:Application is hereby n ade to obtain a permit to do the work and installation as indicated. I certify that no Arork or installation has commenced prior to theissuance of a permit. St.Lucie County akes no representation that is granting a perm t will authorize theermit holder to build the subject structure which is in con fi t with any applicable Homeowners Association rules,bylaws or andcovenantsthat may restrict or prohibit such structure.Plea consult with your Home Owners Association an review your deed'for any restrictions which may apply. In consideration of the granting of this requested permit,1 do heby agree that I will,In all respects,perform the work' in accordance w h the approved plans,the Florida Building Code and St.Lucie County Amendments. The following b Iding permit applications are exempt from unde going a full concurrency review:room additions, accessory struct res,swimming pools,fences,walls,signs,scree rooms and accessory uses to another non-residential use WARNING T 'OWNER:Your failure to Record a Notice Commencement may result in your paying twice for improvementto your property.A Notice of Commen -Commencement must be recorded and posted on the jobsite before the fir t inspection.If you intend to obtain fine Ging,consult with lender or an attorney before commencing, ork or recordingour Notice of Comme cement. Signature of o ner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FL RIDA STATE OF FLORIDA COUNTY OF r . c'�z COUNTY OF n,,l uck The forgoing in trument was acknowledged before me I The forgoing instrument was acknowledged before me this�day o kArn 16i' 26A by' this_90' day of, G�mb Cr ,20 18 by Name f person making statement Name of person making statement " Personally Kno Y OR Produced Identification Personally Known—Y OR Produced Identification Type of ldentifi atlon Type of Identification Produced Produced PATRICIA A.GARY4N PAT EA A.GARYON ate of Florida " otaF ' (Signature-of �a 1 � s} c (Signator ' v 4. & Omff-WF ommiss an FF 133580 :;�9,� it*:; Commission 1 580 F , ''1°� ©d Ttuough Natianai ssn 3unded 7hrou9h ' I�No;ary Assn. Commission No .�3 _ _.,.r :K : _,r. ,w Commo REVIEWS FRONT ZONING SUPERVISOR. PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW .DATE RECEIVED DATE COMPLETED Rev,$/Zj17