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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE IN O MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: GCS Permit Number: Building Permit Applic tion OCT _� 201 Planning and Development Services Building and Code Regulation Division PC T'i I itti fl C� Department 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial en 'r�a'Ivl� C Y� FL PERMIT APPLICATION FOR: )0, PROPOSED INPROVEf1/LENT 1LOCATI®N: Address:-3109 L; fa E2"l I ✓ �. �(� -� L c Legal Description: 4 h e, P 6i. (_1 L 1;t45;e A 16 0h Property Tax ID#: !-70G (DI37 [��J� Lot No. 3� Site Plan Name: Block No. Project Name: Setbacks . Front Back: Right Side: Left Side: NUNN I 111111111"M 1DETAILEDDESCRM, MIN I'M' -IPTION 0'F WORK: W." ,AA6 k r �-"YC S�� � �!ao�,� , n 2u ,A 4--w� 1.,��( 4i,2.c.a S L1," I )42J CONSTRUCTION 1NFOR11/IATI©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 Pitch Total Sq. Ft of Construction: 11�e c> U Sq. Ft. of First Floor: 00 m Cost of Construction:$ 2! C--) Utilities: —Sewer _Septic Building Height: OW NER/LE=MS�SEE: CONTRACT®R: Name Name: v, ill Address: J of Company: R�,C/l/ v� l2iA r/Lv��= City: State: u Address: 24-�2- S C C U I h Zip Code: 3 4 Ct �7 Fax: � � 1�7 City: Qui L State: tJ /I ` Phone No. $ C) 2-' Zip Code: 3 Fax: E-Mail: hS ZA Phone No Z �5 O-C-i -7 Fill in fee simple Title Holder on next page ( if different E-Mail d" 44 )k, � �'►+.eyl from the Owner listed above) State or County License aq(()�2 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. Sl1PP'LEl1lIENTAI. C®NSTRl1�1"I;ON LIEN LAIN 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: 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 with lender or an attorney before commencing work or recording our Notice of Commencement. Signature of Ow er/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORI COUNTY OF COUNTY OF th r�Z'41 A The forgoing instr en was acknowledge efore ;?�k'A, The foing instru int was acknowledge efore methis day of 20by = thisday of 20 by ^` V cid Y-A __rr,�L� h m� Oc)h fir (Name of person acknowledging) 2 �,� (Name of person acknowledging) 2 9�= P ` 5< P3 cn d ' �o= �o m w Z c v w Z c (Signature of No Public-St e of Florida a (Signature of No Pubc-Staeoloaop g� / Personally Known v OR Produced Identificatio Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced 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. 7/2014