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HomeMy WebLinkAboutBuilding Permit Applicaiton ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ( ` Date: / ` 71-1. I ' Permit Number: 1b7/ d VOL( r S. 4-1: -, vo Building Permit Applicatior �r �q02�Z0, - Planning and Development Services crow 9 Building and Code Regulation Division Y% QAa t ;09 g 2300 Virginia Avenue,Fort Pierce FL 34982 �`ry`idtment Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential K 1 PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line i PROPOSED IMPROVEMENTpLOCATION: (� Address: (LIS) 1�-S)( -t_ / 4 Legal Description: l s r,_ ✓i,c_ 4+ / Property Tax ID#: i/5O'/ 70Z_- OO &(^ ©©O' 1 Lot No. 1 Site Plan Name: t Ce-s1ABlock No. Project Name: (&-'\ 1�5110vt.�-c_ Setbacks Front I Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: Rex,,►. $ r- t & 1i bc.vr , sir z�-2„. sig II II 63 x -o ' _ _Lytt,/- ,- , CONSTRUCTION INFORMATION: Additional work to be erformed under this permit—check all,hat,apply: I El HVAC _Gas Tank nGas Piping • ]Shutters Fl Windows/Doors "'Electric 0 Plumbing Sprinklers I I Generator E Roof Roof pitch Total Sq. Ft of Construction: S . Ft.of First Floor: Cost of Construction:$ 2_2.__©0 -r— Utilities: Sewer 0Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name S k e4pp v Name: C..044-15c 'Tj , r• Address: 17_131 F. :be_ Lrt Company:( R— 16om1I.c124-S City: ,ce.I.SerN.6-rA ,L., State: S- Address3231 $e 1>a r.14‘ ',..c1/4 'Telt Zip Code:.3P1547 I Fax: City: c,+cafe State:FL Phone No. 1 I.-Z 3(12...7 X/o ( Zip Code: 3 1-41 9 bi Fax: E-Mail: Phone No. °"'ZZ i Z i — OsO , Fill in fee simple Title Holder on next page(if different E-Mail: C (- 6 u. .e4--- _ C_-0 ! from the Owner listed above) State or County License: SL L. Z-?v a % CA-c 16 7'z-1t If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. ' 1 SUPPLEMENTAL CONSTRUCTION�LIEN LAW INFORMATIQN DESIGNER/ENGINEER: UC Not Applicable MORTGAGE COMPANY: PcNot Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: v(Not Applicable BONDING COMPANY: .Not Applicable Name: Name: I' Address: Address: i 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. li 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, 1 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 your Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder !! STATE OF FLORIDA STATE OF FLO I A COUNTY OF af -4 \ COUNTY OF '\ The forgoing instrument was acknowledged before me The for oing instrument was acknowledged before me this 17S day of THrw -y ,20`/ by this I6 day of I-A, / ,20 1, by C-004 c T-'cl-.4)'- ( }r¢-J 5 --t et. Name of perso making statement Name of perso9,naking statement Personally Known V OR Produced Identification Personally Known f/ OR Produced Identification Type of Identification Type of Identification Pr,�du• — - __ Produ -d - t� I ti''"' ,, JOSEPH ,All ,,ltti' " •:J• BADINI 1 :• is'r ..COMMISSI'b�r (moi 2 p..,,,,.._:;-.4 i• v•,,,,1 • #GG 2742 ji ,12,(:,L..„,......._i ►.I_ 474;:: '.�i iItiWi ' Zi l..Z"iirA .l �. I .4 ,'"?"', ,•r2S ,' na 1_11 ril'1i1 r f �;�;�.�...t Iii • -�ri'iat.•' 1i,.�.4:r.iui='ud'j.1:1.r_LA Commission No. (Seal) Commission No. (Seal) J I, REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE , COMPLETED Rev.8/2/17 ' 1