HomeMy WebLinkAboutBuilding Permit Application Feb 22 2019 10:16AM HP Fax page 3
ALL APPLICABLE INFO NI !ST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ^-
! Permit Numb r•
V 1
RECEIVED
i' FEB 2 2 2019
Building Permit Application
Planning and Developmeih !Services ST. Lucie County, Permitting
Building and Code Regula Qn Division
2300 Virginia Avenue,Fo It�lerce FL 34982
Phone:(772)462-15531 .Fax:(772)462-1578 Commercial Residential 4
PERMIT-APPLICATI�N FOR: To Select from dropbox, click arrow at the end of line
ip
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Address: d► Dr e e
Legal Description: 'f\p dZ a 3
Property Tax ID#: - CIO - 09120 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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4ay a c f. 4 �+ a► a i 14 4 S?.3 74 r + -G cv- I e-
oo YLIaAJ .55 1�6 301L /QR1n)311 1, g1g
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itiona Woric to be .e..ormea uncler this permit-cneCK a apply:HVAC as Tank alias Piping _Shutters a Windows/Doors
Electric :lumbing Sprinklers a Generator Roof Roof pitch
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Total Sq. Ft of Constructi4 : / Sq.Ft. of First Floor:
Cost of Construction:$
Utilities: F Sewer aseptic Building Height:
- _ ,_�i vD 1:47 - .y 3. a, •h, - -�`hf �.: i -
Name 3' ` y ' iNn. i' s
r-Ar Narne: o of E N ri 'l' w,.
Address: d 104 a Company: 0c f G iv f d
''City: State: Address: -` S t U bs' e r
Zip Code: 3 ! ' Fax: City: !' Stater
Phone No. ?� - ��3 zip Code: 3 2 Fax: 7,� -Sr(sb� G6/3
E-Mail: Phone No. ^ G�
FIII in fee simple Title Hol er on next page(if different E-Mail: Gi i r Cc, o®- ot G d a a r�
from the Owner listed a Ove) State or County License e,/¢G
If value of construction is$fi;00 or more,.a RECORDED Notice of Commencement Is requirec.
Feb 22 2019 10:16AM HP Fax page 4
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DESIGNER/ENGINEER: ! _Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip; Phd `e Zip: Phone:
FEE SIMPLE TITLE HO l�ER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name
Address: Address:
City: City;
Zip: Phq .e: Zip: Phone:
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OWNER/CONTRACTO( A; FFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
1 certify that no work or ins t 'llation has commenced prior to the issuance of a permit.
St.Lucie.County makes no rt�resentation that is granting a permit will authorize the permit h Ider to build the subject structure
which is in conflict with any. pplicable Home Owners Association rules,bylaws or and covens its that may restrict or prohibit such
structure.Please consult wi your Home Owners Association and review your deed for any r strictions which may apply.
In consideration of the gran Png of this requested permit,I do hereby agree that I will, in all re pects,perform the work
In accordance with the app wed plans,the Florida Building Codes and St.Lucie County Amen Iments.
The following building perm ;applications are exempt from undergoing a full concurrency rev ew: room additions,
accessory structures, swim hg pools,fences,walls,signs,screen rooms and accessory uses t another non-residential use
WARNING TO OWNERS four failure to Record a Notice of Commencement may resuit in your paying twice for
improvements to your p roperty. A Notice of Commencement must be recordE d and posted on the jobsite
before the first in"SpectIc in. If you intend to obtain.financing, consult with lend r or an attorney before
commencin 'work or r0q4orcling your Notice of Commencement.
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Signature of Owner/Lessew /Contractor as Agent for Owner Signature of Contractor/Li ense Holder
STATE OF FLORIDA I i! STATE OF FLORIDA
COUNTY OF c , G COUNTY OF u Ci G
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The forgoing instrument ` is acknowledged before me The forgoing instrument m as acknowledged before me
this day of 2d— by this 611day of z'h tu a r 20_ by
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Name of person 'ling statement Name of person making statement
Personally Known *bR Produced Identification Personally Known OR Produced Identification
Type'of Identification Type of identification
Produced Produced
PATfngA A GAltMb111
a
(Signature of Notaryo % (Sig r ( d
Baddltni /Weud�im `} OMES October 23,200
Commission No. Comeal)
REVIEWS FRONT, ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNT REVIEW. REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED `
DATE
COMPLETED is
Rev.8/2/17 I
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