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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: � - I �- 18 RECEIVED PPermit Number: 1&P--© ; '0 _ _ _ DEC 1 1 1018 • . ., . k E .: .t~ Per Department CY LI PA St, Lucie County F L 3� 9'd D 0 P. — r ,,____.,______^__,-_w.__ ___.--_._ _-_ Building PermitApplication Planning and Development Services Building•and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 C. Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: A j c - y ya o i • n .r ..,:,,.•' ., -`--1,:.-J':-.7f..4 # ,.....,. ..,::.',0. .s•. t..,n ••,-,:g4.-.4-.....:_ ,. H, .. `.,e ,. Address: /X6'75-- cy,Or C.-)770r(- / - ' Legal Description: L 36 '3, /vim Property Tax ID#: 308E --/`/ - 600 2-- 606 - Z Lot No. Site Plan Name: Block No. II I Project Name: ,� Setbacks Front ! Back: /" ' Right Side: 14 Left Side: iet/n_ ' I f �� Cc , /leet4(r�ei.4 5�� /41,-G// `a cs; 1 .4 xf t� i ' C 7. A '"' : . -._ v. _ • yr,$, . ••itiona wor to .e pe orme• un•ert is permit-c ec a t at appy: II _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doorsli Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ P)-%) Utilities: _Sewer _Septic Building Height: t...,. ..-....;.:.t.,, Vit` :i L>L • ,. , i' Name LA- ' -.1- ' L =` 7 .. .moi A'1-6,-- C. E-UM,f1J • _:i �1�. .,, .L Name. Address: etag 1, _-fi -7.1 -eYj'ig- Company: 7/o.10- R scat ,J el. 1;/e- - - City: fQCc IRO J" State: t--- Address: /612 5 73ii✓T ../z6 57- Zip Code: 3,3 H3_' Fax: City: f SC State:'. Phone No. Zip Code: 3Kfl7'9 ' Fax: 3/6--5624 E-Mail: Phone No 7?2 -3 yo - c K593 Fill in fee simple Title Holder on next page(if different E-Mail Dido€cr5 c-P—r) e friJ'', Gem from the Owner listed above) State or County License 4-703 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. I AAI 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: ,1 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 CountyAmendments. 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 f-`lure.to Record a Notice of Commencement may result in your paying twice for improvements to yo pro• •rt .A Notice of Commencement must be recorded and p•sted on the jobsite before the first in io . If y•u intend to obtain financing; consult wit -nder or . {attorney before ' commenc_ ing w• •r re,ord' gyour Notice of Commenceme• . Signature • Owner/L:ssee/Contractor as Agent for Owner Signature o Contractor/ cense Holder STATE OF FLORIDA I STATE OF FLORIDA • – y COUNTY OF ' ,5 '(.q Ce COUNTY OF si -Lu Ci- The forgoinginstrument was acknowledged before me The forgoing instrument was acknowledged before me this ( ( day of O-esz ,20!Eby this I f day of ))-r C__ ,20LL by Mk C)ock Cl Onnc(f (\ Chckf- N k l4k) (Name of person acknowledging) (Name of person acknowledging) . O Al AA a ure of Public-State of Signature of Notary Public-State of Florida) (Sik--------- EAkikt& - Notary Florida)) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced FL9 Produced pi.— L- F r -� �`�'�`Y"�'% ELLEN '°,`11������=State VAUGHN Commission No. I :�^�` Is of Florida Note H P A $ Commission No. l _ Ida-Notar Public viii• , o missfon q GG 2� 'blic �, y .�,�����' y Comml®elon Exali oe Commission#GG 270079 „a���^.�� M; 0':78 %,?o �.� My Co Fri Isa •. i e, • odtober 22 2Q22 - "r2 i REVIEWS FRONT ZONI"G 6 . PLANS VEGETATION SEA TURTLE MANGROVE ' COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE l . COMPLETED Rev.7/2014 i