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HomeMy WebLinkAboutBuilding Permit Application (2) All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: i 0'-- 16— ice Permit Number: l '(O ---0 .27 41111111 1 ©C.naL et e , ld 'A unn an 1 iimmemminismaimilm Building Permit Applica ion w4aeda® 6ui4lwaad Q A Planning and Development Services 81OZ 5 1 130 • Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Re i aaAr33311 PERMIT APPLICATION FOR: PROPOSED IN�PROVEMENT L® ATI® j _; ., .),.'Yr. - ; , Address: t'6 17 ii e OLID -!r Xl 1"—r, '?l i-iec- . ` 349 s y `• Legal Description: )"\--1,)"\--1, [ ( S l/.) S-91.,,_a ���`i Lei 7 t lid — //i10 Property Tax ID#: LI- 6 ✓ ( 0 )-- r 00/e - 000 — U Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTI®N'G F W®RKi: 1 ,' 4 < a Q j./fo,grelelih /;dere SYier r- ile? ,voci mia pnei-(er-y--,-c_�� .. Ae/o(4.47' i Over Je-cz- w c�cl Service umdec ro .-rc/ CO STRUCTI® IN'FOR ATI®N -i:1--!,.. - .;. - :- .Ae . ..-. Additional work to be performed under this permit—check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors IElectric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: 1 Sq. Ft. of First Floor: Cost of Construction:$. 6.300/, b 0 Utilities: _Sewer _Septic Building Height: ?01NNERNES�SE ': .... ., '' �°CO T ACT®R° ` '. ',— $..‘. .i: Name 4t4, ,a.. ' ) ". Name: rn L/ f':1/41 `r Address: '2•••`e-)-'3``"M`Of_1.?r::,.V/ 7( its" Company:; &; e 2 Mil( City: c? 49I . 'g 'rj i State: P-' Address:.. Z� cam, Zip Code:3 /b Fax77)-" / / 'Fre City: L✓I6 / State:F2- Phone No.7 7).- n I// 73 0Zip Code: _3;i/el7 Fax: E-MaiI4-L-e,6W 14 0 6- lj/f/2 Phone No (SG/)/ 3/-3-2-46--1 Fill in fee simple Title Holder on next page(if different E-Mail ..:-.74:44.9 c_l� Z/el( ( ttP-`-C-A"\ from the Owner listed above) State or County License-77P5: eg /3o/97. 9 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. 3PLE f 1 �t€Cars '.'UC tI®N a .`Fa.f1Vl�,T d ; : : t'.34:1,1!:•�0 `'� ' t :tf , .` ,-„,.;.,,.-....A. .,.0 a .„,:. s 4...;, .,�.-. .-.%'4-,...- . •”. _. -... ' te` a1:'''9:' -.i,77,1° ,. ,t DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: -- -_...._ i Address: :qity: i. .':, State: City: State: `..Zip-;, -. :•, ., Phone' " ` , Zip: Phone: FEE SIMPLE TITLEHOLDER: ; Not Applicable BONDING COMPANY: Not Applicable Name:' • Name: Address: :.f; Address: city City: ,,Zip:'-'._...y __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 aridreviewyour 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 wor or recording your Notice of Commencement. )c / , , e i Signatu a of wIl .ee '.n ractor as A:- t or Owner Signature of Contractor/License fol er STATE OF FLORIDA STATE OF FLORIDA COUNTY OF Tna,,p4\.) 'A"'•\\R.41., COUNTY OF 0-4Vtr_ ecz c__h The for Ding instrument was acknowledged before me The forgoing instrument was acknowledged before me this Q ay of C -b\erce" ,20 R by this I 64-day of 0e--I, ,20115 by Mc h. `)ar1A- .\3e 5 Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification `‘--. - -Type of Identification– — _ - Type of Identification– . _ Produced FL_a.-r-0-01)–SL)–)t-I-44-6 Produced-(tZbA nCal er L`c,en'E- Ctt k e_•: z3- (Signature of Notary Pu.li -Slate of Flo ' (Signature of Nota Pub• � BUC il 4/";"•� DANIELLE L HARRIS 1,,- NOTARY `� , Commission No. I _ `_ (moi}State of Florida If STATE s -IDANotary Commission No. 4. = �r :� Commission N GG 256950 y- ccovii#PPP,.70 z.P.C5.. My Comm.Expires Sep 10,2022 . �' Expires 11/18/2019 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION ' SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE , RECEIVED DATE COMPLETED ev. 8/2/17