HomeMy WebLinkAboutBuilding Permit Application ,f(iin
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.0- ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: i—lip-1 Permit Number: 11 CtOk."
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!r.:::c.1,c.,,,R i 4: tii icAr';.. RECEIVED
- -iimtlifti iiiiimemp-*------ Building Permit Application JAN 1.6 2019
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie County
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential k/
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address: 3 P.a7 6,i'v e., ocds..... Lcre_ - t
Legal Description: KiAl edt- Oak E.---3 i-c+CS
Property Tax ID It: ).Li 30 -30.).-6:34-0-1-000" g Lot No. (-ii
Site Plan Name: Block No.
Project Name: WO i r)ell i P.-
Setbacks Front (1 Back: Right Side: Left Side:
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09NSTROCTIONI::119tORMATIOWi ,.. :: : -.---,,,:--- :-, , :. T
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Additional work to bp4rformed under this permit--check all-..hA apply:
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DHVAC 1 j Gas Tank r-!Gas Piping Shutters t„.." Windows/Doors _...1
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E 1 Electric 7 Plumbing Sprinklers Generator Roof
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Total Sq. Ft of Construction: SI:_i . of First Floor:
Cost of Construction:$ D•P(3 - OO Utilities:1 'Sewer Septic Building Height:
:,0,1%\l,p314$,SgV:;!ii-31i . .;ic. .,_::,z'i,..:1- ito ISITWAOrtiitf;,':4:'Ll:-',1A-::','::: 0,411'4.''.d-',V:::,.c.'‘':4:::,ii,Vg..1111
Name 1)CI\Ili S COO r\c:) Name: , - (-
Address: ?o?a? Li v e. C)a fr.._ Cc- - Company: -4-C-) Oct..1---,iy -.0,-k--cit.;Dt--Ai (-)
City: rd r i Pk cir-c.fe.) State: Fl Address: 1:2)4 fu21 -7 -t- A9:Til 0 .2)
Zip Code: gcl 9R I Fax: City: i C. 'Irkm kvv-r:TP) ----c-,o i,.., State: F L--
P hone No.--)-)c2 -5?6"-0(9 2 cil Zip Code:13SLI 1 '-.)-- Fax: 5-1.,,
E-Mail: Phone No. 5-b i-
Fill in fee simple Title Holder on next page(if different E-Mail: c /-1. ,0. .-., -,
from the Owner listed above) State or County License: (.2. (.9 k....
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If value Cif constructiOn is$250c)or more,a RECORDED Notice of Cornmentement is required.
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DESIGNER/ENGINEER: . Not Applicable MORTGAGE COMPANY: Not Applicable
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Name: Name:
Address: \ Address:
City: State: Citv:__ 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:
I certify that no work or installation has commenced prior to the!ssuance of a permit.
St. Lucie County mak9s no representation that is granting a permit will authorize the permit holder to build the subject structure
which����'..conflict with����������. ����ble Home.,..ers�������.~. .����,.~~or����.d�� .ants that may�������� ����._'_ prohibit such
structure. with your Owners and your any may apply.
In consideration of the granting of this reested permit,I do hereby athat I will,in ll 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 nonresidential use
| WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to rty.A Notice of Commencement must be recorded and posted on the jobsite
beforyou intend to obtain financing, consult with lender or an attorney before
•r recording your Notice of Commencement.
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_Si�����O�ne�Lessee/Ag � 5i� Contractor/License
STATE OF FLORI . STATE OF FLOR
COUNTY OF COUNTY OF Qc /'w) sgo,c h
The foinstr t acknowledged. re me
Thefo instrumentwasacknow|edg d before me
this*�a/� , of 20 Yhy this /^idayof .�^t:Io^l- ' 20 /�) by
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1) e°1!3' ,1r)a r Jot Kyle 5 D
Name of person oW|edgi ) (Name of person ocknmw|egging)
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(Sig. a^~/ Nota flic.State of Florida ~� Nctryub|ic-5ta
eofFlorida)
Personally Know ~ OR Produced Identification Personally Known � 'O
RProducad |den�fcaton
Type of|den l� NANCY E
AJANS Type of Identification Produced
try Public-;tate 9f Florida Commission No *ix. :...4::;,4-4.57-:.,..„;
~h ional--'--. Commission No. � ^ my suxvpm
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���mqBudget wLavServices
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
I COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE |
COMPLETE !_ .
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INITIALS — II