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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I Date: �( Jr Permit Number: �.� ` — a 0315 F RECEIVED ,a -- - - Building Permit Application Nov o 5 2018 Planning and Development Services BT, !NGI�County, Permitting Building and Code Regulation Division ---- 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)46271553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: 1 - , PROPOSED 11R'ROVEMENT LOC T reN Address: Legal Description: Property Tax ID#: Q lJ Q o© Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DET ILED DE�SIPTIUN l�F WOR C he Z, a om-o CONST UCTI:+� INFOR ATION: itiona wor to a pe orme un er t is permit—c ec a t at app y: —Mechanical —Gas Tank _Gas.Piping _Shutters _Windows/Doors LeElectric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: n �(�00 Sq. Ft. of First Floor: Cost of Construction:$ �Q�ok Utilities: _Sewer —Septic Building Height: OWNER�LE�S�S CONTR �1'C1R: Name a/y d7U l rt(d ,,Name: C Address: 1t 8Q TC��a m_�ej i mpany: o City: foci 1e F,I Gt State: Zip Code: 3 0cq Fax: City: State: Phone No. 7,7a-.5-1 f— oa 8 Zip Code: Fax: E-Mail: ShrU e (K X17 i6t 6 lk(-614, Phone No . Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENT I.CONSTRIJCTI2,N LI'E LAIN IN'F®RMATtOt .: 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 Owner/Cesseelo ntractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDASTATE OF FLORIDA COUNTY OF o4Lu• CCIt COUNTY OF The for oing.nstrurpqnt was acknowledge(�efore me The forgoing instrument was acknowledged before me this day of 2065 by this day of . 20_ by Name of person making statement. Name of person making statement. -7 Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification,. Type of Identification Produced l. Produced _:!J:LA Q A A C (Signature of Notary P (Signature of Notary Public-State of Florida) KAREN S. NIELSEN Commission No. ,r° °"-State o(1,�{.SP 'da Notary Public Commission No. (Seal) ,�F ComrrlISSi6n # GG 207484 =0 ��, My Commission Expires REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.