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HomeMy WebLinkAboutBuilding Permit Application I All APPLICABLE INFOMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED SO __ , Date: l vcvie ' Permit Number: tSO 6/0.5 I r.,,,,wity,-6,. ...:.4„-,,,_ --,,, , , c CI Li Mir>r -,_ F L O R 1 0 F -,- Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: PROPOSEDI�IINP�ROVEME T:-LOCATio „. : a. , S ti -'AY'A-k Address: 7 �� �" ` Legal Description: /z LOT 2. /i 2 4t/ ` ©vz- Q,7 Property Tax ID#: 3 U Q D.""L.,, Di — 0\ %o 0 Op" 1 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: I D TAILED D ESCRIP: ION, .W®R . .. .. �Y v . Pge vd.•i. �� b i� 'Cif Sy '' 'n5 wel ��BGA' JJ ei '� crnd �Yiuse, i iio LP C®w T°�UCTION,'N!I®RMATIONg .., „ : : . ,. _ , . Additional work to be performed under this permit–check all that apply: _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:$ 2)G tJ ► 00' Utilities: _Sewer _Septic Building Height: ' n,, 4 .O ER/LESSEE?' ! ,, . *: ® CONTRACT ° ' , ` Z7_ Name " -' )12 Name: Address: .10 S; �XIG'A -,0Z.) e"`-r-441/.. 5 Company:. ' City: i'-'7 ,--2 CState:El Address: " ' ' Zip Code: 59962 Fax: City: State: Phone No. 7 72 , '7 D 8^ 2 N-7 Zip Code: Fax: E-Mail: -I-4000n . Mkrl( 32 gylq 'j_(. 1 Phone No Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License t If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. UPPLEM 20®NSTR CTI® linklUEN DIA '®RMATIONo a, , :A ;, '. e .,, 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 represu sentation that is granting a permit will authorize the permit holder to build thesubject 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 r, rding your Notice of Commencement. -it 71/64t7- 4c0.1_,, Signature of 6 r/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder , , STATE OF FLORID STATE OF FLORIDA COUNTY OF FLORIDA- C—u C le COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this �i day of /O/.9/, ,20/1"" by this day of ,20_ by If,1 CI ✓K .1 a CCU l'ASlN Name of person making statement. Name of person making statement. Personally Known OR Produced Identification 'D L Personally Known OR Produced Identification Type of Identification Type of Identification Produced cL_t L__ Produced (Signature of Nota' �'�o a - , (Signature of Notary Public-State of Florida) kot�Y°vs. • V�UGHN ��i '_State of Florida- tary Public ' Commissio( Commission No. (Seal) Commission No. =a.^,f; G 270079 %;f!;ii,i r` 'y Commission Expires October 22 2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW • REVIEW DATE RECEIVED DATE COMPLETED ley. 8/2/17