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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE'COMPLETED FOR APPLICATION TO BE ACCEPTED - ` . f !� Date: �: \0 1� Permit Number: 1%-10 a- 0 6 0$ 13 IF ILC0R. 111, Fk - -/J Building Permit Application �% �F� `�`rG Planning and Development Services < % e9 Building and Code Regulation Division °%,4p ��� 2300 Virginia Avenue,Fort Pierce FL 34982 �9 Phone: (772)462-1553 Fax: (772)462-1578 . Commercial Residential �- PERMIT APPLICATION FOR: .PROP®SED I1NfPROVEM °LOCATIONp 4; . .:; °° ; Address: RO !, 7 ST CT F-T Rrc.e F' Legal Description: r rusty ��Iyl.fs .81 K 1 2 Property Tax ID#: a(06 - CO -61 c6 -0°07 / Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: ©WAILED DE�SCR PTION OPnW®RK® ,e' :.:.i' - ' y .: .. _ u ,V s (1 3-w 140t4,sl 1 Der ,� ' --- -ja 'CO STR CTI® IP®R .AV.M, g, .. . s . ‘'': ads Additional work to be performed under this permit-check all that apply: _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:; .I�'S Utilities: _Sewer. _Septic Building Height: r I • • .®WN R/LE-'SEE; °/ : . : � .CONTRA ®R° .. , c:..,°.,-: . '.. . r G-G'vl/ e ,#/# .Z- , Na, - .,SSo c..ai-e N Name ��lr/- .. ; Name:: �. � Address: '' �` fly 9,..:/ � �t 4 Company' .h1'r\ C Ci r-?`C City: /5 G. ,. . State:/- Address: M`.? - 5 .. ikcJcun KANi- 9r.V� Zip Code: ��/�/Jf�(P(///ffj' 3 Fax: ; City: T ;2rce State:FL Phone No. 9'•rTii,,o''' " 4/ 9,5"-' Zip Code: .31/4f qso Fax: E-Mail: . Phone No-M 834 70© 1 Fill in fee simple Title Holder on next page( if different E-Mail from the Owner listed above) State or County License c (rC 1 SI 3 3 6 0 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. • P. . EME�N1m ost7NS KUL.IION LAW®l�N ORMATI0 g .. - , `. ..�_. - &u. _ - \ '�'la °`&�' ti, i,➢Y. .,�,,',` 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 4) 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 e first inspection. If you intend to obtain financing, consult with lender or an attorney before com ,e cing work or recording your Notice of Commence • t. 1 # Y. '0• / r —6 _,....."----' Si'-"rture of fawner/Le .1- "ontractor as Agent for Owner :nature of ontractor/ ' ense Holder STATE OF FLORIDA STATE OF FLORID ' COUNTY OF ST Lot:, COUNTY OF LUC•c The forgoing instr m nt was acknowledgedpbefore me The forgoing instrument was acknowledge before me this day of II9rtktry ,2O) 1 by this 611•day of IebruAry ,201 by 1'k LA r&-P®r9e 1)hh CreOry Name of person making statement. Name of person making statement. Personally Known X OR Produced Identification Personally Known X OR Produced Identification Type of Identification Type of Identification Produced Produced 5trikt: \)fecsiv\-isi. 111 ) , , 1 , of NotaryPublic-State of Florida (Signature ) ;( is nature if Nota ' ,.. '_ _ .� ,•.,i•. „ Public$tate of Ronda Q�yr°aM Notary Public$tate cif Ronda Commission No. 4,0114.(S ry Cor mission No. ? NI Sophia Harrik5eai) ' 44 11 Sophia Ham's c , M Commission GG 238873 My Commission GG 236873 g7 Y Ex 'res 0513012020 ‘0,pd* Expires 05/30/2020 arL , REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW. REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 8/2/17