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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED n Date:�(� /(� Permit Number: r + _ Building Permit Application OCT 0 8 2018 Planning and Development Services Building and Code Regulation Division Pei i"i;i'CLI i i , 4j" epa!"tment 2300 Virginia Avenue,Fort Pierce FL 34982 I UCi Oy' FL Phone: (772)462-1553 Fax: (772)462-1578 Commercial • eITUaI PERMIT APPLICATION FOR: PROPt�SED INPR01/fMENT LOCATIQN: Address &� s• iH �" � %�/eRe c_- Legal Description: /Y4191Z_X �'/�C /�X-1, /.� S 41111 S Property Tax ID#: 2�, 7` IO 10/F 0-0s totD Lot No. 113 Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETA6LED DE.�SCRI�PTION H3F WORK; - � Fe-SSS CC}hLSTRUCT(ON INFQ NATION: Additional workto be pertormed under this permit-check allthat appy: Mechanical _Gas Tank _Gas Piping I Shutters —Windows/Doors,: _Electric _Plumbing _Sprinklers _'Generator _Roof Pitch Total Sq. Ft of Construction:, Sq. Ft. of First Floor: _ Cost of Construction:$ y 0 I Utilities: —Sewer. _Septic Building Height: ®W ER/LE�S`�S9E: CON RACTOR: Name .��//G Vii✓- IC Jr . Ge__ Name: .!"';?'V T. �D Address:207& te, dfiq Company: City: �-Afs State:J5L- Address: /.��7�% ,�/✓ ac/, P//_s'�''.1`. G/i �rl`0 Zip Code: _?V'-?'/V7 Fax: City: State:__4'/_ Phone No. 6 f 1•- %'1ST ) Zip Code: Fax: f��� Fax: E-Mail: Phone.No 7 727—/�'l_ Y--4-2, ate Fill in fee simple Title Holder on next page(if different E-Mail -J—\;V/✓f0 f�iM1✓ilj''�i/� from the Owner listed above) State or County License e/7 1 /217 f If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL UNONSTRUCTI©N LIEN LAW INFORMATION: DESIGNER/ENGINEER: of 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. L Signat of wner/ essee/Contractor as Ag r Signature of on or/License Holder ;°'%n•rt•;'c' STATE OF FLORIDA g STATE OF FLORID ,. COUNTY OF COUNTY OF m 9�9 The fo oing instrument was acknowledged f grNt The f oing instrument was acknowledge o m this day of C� 20Lb by this T day of 20 m 9 a-- o (Name of person acknowledging) a (Name of person acknowledging) oA N J (Signature of Not Pu ic-State of Florida (Signature of Not Pub ic-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification / Type of Identificatio Type of Ident' is ' n 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 Rev.