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HomeMy WebLinkAboutBuilding Permit Applicaiton All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 1"2`/— /?/ Permit Number: I '.C? I .(D '� C Olt Li IJT F L D R 1 D R - - Building Permit Application kecei Planning and Development Services 4,44 FO Building and Code Regulation Division pa,. 3 02 2300 Virginia Avenue,Fort Pierce FL 34982 s�� `%n9 Ig Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residentiah4% epe,e,, PERMIT APPLICATION FOR: PROPOSED [10)°13\M ' Mg OCATIO .: : '4' . u,p Address: r a P./ So y. LCA Legal Description: /1 f'o n manor SSD- unit / - 81/-‘/- 1-or a-i' Property Tax ID#: =2 3 O 3 b I DO O-'8O Do I Lot No. Site Plan Name: Block No. Project Name: , Setbacks Front Back: Right Side: Left Side: EWA LED DESCRIPTIO OGS;WORK°..` eq WOoc/en Fence bxg 3haclo,v Fox o --1-67-A4 ,Z Li— A ;11') and C"e. $ CONSTRUCTIO INFOR MTIONi .', Additional work to be performed under this permit—check all that apply: I . _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: $ lj33'O0 °C Utilities: Sewer _Septic, Building Height: OWNOR/LE=SS :to '°` ' ONTRACTOR ", Name s,mhF'c 1y E\I-0 r) Name: Address: 1 a 14 W. �) Lc Company: City: r--/- p,e;c FL State:FL. Address: Zip Code: 31194/5- Fax: City: State: Phone No. 772- .1J o — O'?/9 Zip Code: Fax: E-Mail: 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 CONST'+UCTI©N MEM MM IN.®RMATl®No 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 your Notice i` a " '3d` ncement. x i fo':3 xt Signature of Own r Lessee/Contractor as Agent for',aitnekSignature of Contractor/License Holder � a XnY STATE OF FLORIDA mm STATE OF FLORIDA COUNTY OF ' ` d _ COUNTY OF The for oing instru nt was acknowledged before '- �T= The forgoing instrument was acknowledged before me thi day of �, , 20 19•by • a oA RI this day of ,20 by ` ,tb l v2s• Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Id i is ' n �/. Type of Identification Produced • a) �J C Produced (Signature of No a y Public-State of Florida (Signature of Notary Public-State of Florida ) Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED rev. 8/2/17