HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: d Permit Numbe:
Building Permit Application SEP 2 0 2018
Planning and Development Services
Building and Code Regulation Division Permitting
2300 Virginia Avenue,Fort Pierce FL 34982 St L Cc
Phone: (772)462-1553 Fax: (772)462-1578 Commercial
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address: ( S vi 33rd S+ICCje*-
Legal Description: 'SU()l ana Gn C'e'LIZOS
Property Tax[D#:;)qc)5 -G6( -Co3G3 "GOO -(-o Lot No. I
Site Plan Name: Block No.
Project Name: Ge—or-w, '(C4L�e_ (f&OW&
Setbacks Front Back: Right Side: Left Side:
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Additional worKtobe performed unclerthis permit—checK all that apply:
1]HVAC F] Gas Tank E]Gas Piping FIShutters 1216"Inclows/Doors
LJ Electric Plumbing OSprinklers El Generator Roof
Total Sq. Ft of Construction: S Ft of First Floor:
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Cost of Construction:$ 9 1 -LIS Utilities: Sewer E]Septic Building Height:
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Name e)0- d
Address: 1(46 Z U 33 rd S4 ruLt Company:—'_.V',4_C)
City: State: L( Address:
Zip Code:LN1 q 7 Fax:- city: I k; State: 1E
Phone NoJ-)a -q-?q -OQS;) Zip Code:3 SLI I D-- Fax:-5
E-Mail: Phone No. 51:1
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License:_0 63 31'
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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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:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie Co_u_nty 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 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
coMTencing work or recording our Notice of Commencement.
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_Signature of Owner/LesseeAhetlt ature o Contractor/License Holder
STATE OF FLORIDA STATE OF FLO
COUNTY OF �S-j- k u C,e COUNTY OF Beech
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The forgoing instrument was efore me The for oing instrument was acknowledged ore me
this 5' day of 20 by this�day of 2C by
(Name of person acknowledging) ' (Name of person acknowledging)
q"�4�
Signature of otary Public-State of Florida) (Signatur of Notarybl/ic-Stat f Florida)
Personally Known OR Produced Identification Personally Known �/ OR,Proclucecl Identification
Type of Identification Type of Identification Produced
0y PUB
Commission No. =� • MV C FFl35458 Commission No. o �, (�NQ�G�YOUNG
_ •. * h11 COK1kI uy!ON#FF 951069
EXPIRES Novi 11.2019 sr Jr EXPIRES:ApdI 12,2020
Revised 07/15/2014
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS