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HomeMy WebLinkAboutBuilding Permit Application ALLAPPLICA13Lki FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED `c� Date: Permit Number: 1 `0 RECEIVED Building Permit Application FEB Q 4 2019 Planning and Development Services • Building and Code Regulation Division ST. Lucie Co ty, Permit till 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line 'PROPC)SED f!VlPROVEM'E.lVT LOCATION Address Legal Description: (ME 13 t Property Tax ID#: to ILI — © — Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION C)F 142d mio i W-cxf) -5, CONSTRUCTION INFORMATION _.. itionaworto be eormeuner tismchecka appy: C MVAC Gas Tank ❑Gas Piping _Shutters fv�windows/Doors Electric rI Plumbing Sprinklers 1 Generator 11 Roof Roof pitch Total Sq.Ft of Construction: S .Ft.of First Floor: Cost of Construction:$�'•�� i Utilities:,n Sewer Septic Building Height: 01NNE'R/LESSEE = CONTRACTOR Name — Name: Address: 1 'e-- Company: City:_ , f —State: Address: Zip Code: Zi y� �� G ... Fax: � City: 7r State• Phone No. —oil 7 5� Zip Code: Fax: E-Mail: Phone No. S 2-;—,1 — Fill in fee simple Title Holder on next page(if different E-Mail: KA Q'- md from the Owner Listed above} State or County license: C If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. i -5URPLfME,NTAL C4NSTftUCTtON LEEN{LAIN tNF:4RMATt{JN; 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 Associatiion and review your deed for any restrictions which may apply. in consideration of the granting of this requested permit,I do hereby agree that t 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 rds resu 'n your paying twice for improvements toy r roperty. otice of Commencement must be recoan paste the jobsite before the first ins ect on. If u intend to obtain financing,consu 'th len e r o an a mbefore commencingwor or rVcorcW'ng voutNotice of Commencement. Signature of O er/Lessee/Contractor a Age t for Owner Signature ofLone,,se der STATE OF F ORiDA STATE OF COUNTY O v ci_, G,q` COUNTY The forgoing in rurnent_ as acknowledged before me The f rgoing acknow dgepefore me this da o ,�.20� by this„�daL-n20 1 1 by Name of person making statement Name of person making statement Personally Known ,C OR Produced Ident' c tion Personally Known OR Produced Identificati Type of identification Type of Identification Produced Produced ( ignature of N ary Public-S#a e of Fi Signature of o a u I'c-9 a f r' �sY pue Nota Public Stat ida �r pvQ Notary Public State of F Qed�a Commission o Notary � ��` Commissio {i r\ #I tai Riccabonfi '' —# i M-Riccaboni a My Commission FF 981647 uy _ c My Commission FF 981647 *10. o Expires 05128/2020 ''fiadna4 Expires 4512812420 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8(2/17