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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �1 Date: V I` Permit Number: i C&L Buildhig Permit Applicati n OCT o 1 Za'$ Planning and Development Services Building and Code Regulation Divisions. 2300 Virginia Avenue,Fort Pierce FL 34982 " i' 9 P. t Phone: (772)462-1553 .Fax: (772)462-1578 Commercial Resid laL. - `n ' - s. • L PERMIT APPLICATION' FO.R: WO,PO2 ED IMPROVEMENT LOCA ION: Address: n\ 00 Lo czcca.n-o. . Legal Description: --� �oiz © Property Tax ID#: S" 11Z ,.%-O,�,_ cFTO© - Qj-p o- - Lot No. Site Plan Name: Block No. Project Name: Setbacks -Front Back: Right Side: Left Side: BE: D�CRIPTtON QF WORK: CONSTRUCTION I�NFORMATi� N: Additional work to be performed under this permit-c ec ,a ;t ,at.app y: _Mechanical _Gas Tank _Gas Piping =Shutters _Windows/Doors Electric Plumbing _Sprinklers Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction: $ Do O 0 Utilities: —Sewer _Septic Building Height: O ER/LE=.S�SEE: CONTRA O : Name Ac s 'L P\k7 r.) Name: Q&-c,o gra Address:�l 1 b`� 1-,a ntZf\rr4- �* Company: 9, City: Iq S L StateFl Address: Q�O Zip Code: 3A c'\% Fax: City: 97 (Z-• cZI State Phone No. ! `a (� Zip Code: 3 Fax: E-Mail: Phone No `1�2� a g g '� 3 Fill in fee simple Title Holder on next page(if different E-Mail 'R 1��•e�1?�v� �3�,2 �C7�y��l 1 ar 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 C�NSTRtJCTION LI' LAIN INF'Q'11MATION: 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 be commencing work or recording our Notice of Commencement. co ACE 1?'s o Signature of Owner/Lessee/Contractor as Agent fe 4g Signature of Contractor/License Holder �o m;m STATE OF FLORIDA e STATE OF FLORIDPR d COUNTY OF Ilt Aa X` COUNTY OF Wo 2 MrnTx The forgoing instrument was acknowledg before N�G The forgoing instru nt was acknowledged efor !A this day of 20 by z=r� this_�day of20 by �N C en n,lc �_ vv Eotu'o ) n aenn' aro ��'CS0/ra ame of person acknowledging) (Na of person acknowledging) ignature of N ary Public-State of Florida ( gnature of N ry Public- ate of Florida) Personally Kn OR Produced Identification Personally Known OR Produced Identification Type of Identificati a Type of Idenl"Tc 'n Produced VY C, Produced L,& C 4A/I/ 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.