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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: %j . Permit Number: RFe'r 5c' _ Building Permit Application SEP 2 20t8 Planning and Development Services Permitting Department Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 St. I.0 C I ' County, F Phone: (772)462-1553 Fax: (772)462-1578 Commercial . 11esI entiaf— Q/ PERMIT APPLICATION FOR: PRQPUSED INP DUEME;N Address: C 0M C) Legal Description: Property Tax ID#: 136 �o –' ©e5lFv Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DE�SCR�IPTION aF WOR�K ON"NSTRUCTV&'N 1N&MR, ATI®'N; Additional work to be pertormed under this permit-check.all that appy: _Mechanical _Gas Tank —Gas Piping _Shutters Windows/Doors Electric _Plumbing _Sprinklers Generator ✓ Roof (2 . Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$��- Utilities: —Sewer —Septic Building Height: O ER/LE:�S�S �E: C®NTRA�+TO�i�; Nam c,� �'nN � - ��" 1"l� Name Address: A G Company: - ' City: State: Address: .Zip Cod e::3+42cmo_ Fax: City: State:_T4— Phone No. Zip Code: f>"_C�;B Fax: Cp � E-Mail: Phone No Fill in fee simple Title Holder on next page( if different E-Mail VaM S from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CnNSTR�tJCTIQN LIEN LAW I' FORMATION: DESIGNER/ENGINEER: J/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 wit len/ er or an attorney before commencing w r or Aecording your Notice of Commencement. d' Signature of Owne /L-ssee/Contractor as Agent f Signature of Cont a or/License Holder ,1 1�,•w�Ai'.' o STATE OF FLORID rog STATE OF FLORIDA - m� COUNTY OF '% COUNTY OF xo sm Cn W The forgoing instru nt was acknowledge beforeT,_ m a The forgoing instru ent ways acknowledg d befor 9 52. this day of 20L& by � this day of �}�' ' 20 by �T Qlnse-s '2 m c y,-n 9 �Sa Q, S Name of person making statemen c rnT 0 Name of person making statement. 144 Personally Know OR Produced Identification 1.8 Personally Known OR Produced Identification tio Type of Identificaype of]dent[ n Produced roduced /,&/-)t� Z a (Signature of No Vy Public-State of Florida Y V (Signature of Not y Public-State of Florida) Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.8/2/17