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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: f-1/---'15Permit Number: ( U " 00 19 C 0 o N T RFCF1��� -:-_-----. Building Permit Applicati&of Planning and Development Services �'"m/ttj ?OJ® Building and Code Regulation Division St<1,c9 oe4, 2300 Virginia Avenue,Fort Pierce FL 34982 e�0anty elk Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential _ 1 PERMIT APPLICATION FOR: 1 .PR®P®SED fPR®VE LOCATI®Nd• ° =i , -,s : .' '.'-'. P,;+ Address: 641 (,fit C5 C.._1•._ Legal Description:`1�1.UJ &. '?4k-Q-L V)--KZ -e3 JZ - ZCo L.,p7 a2 Property Tax ID#: S4-t.1°- S\S' O \ -C :D.0.- Lot No. VL_- Site Plan Name: Block No. Zoo Project Name: E-E4"--C-6----- , Setbacks Front Back: Right Side: Left Side: , . .e MAILED DE�5CRIPTIO 'F WORK°tl ,-, I °.x Iios1c*c LUJ(' (c- U1 c-- cn' '?(L1UfrC_'j e€'6 I C® STRUCTIO { ] FOO RMATINg& ° '...°4;. " • < ", -.;:i ..1:' 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 c,N Total. Ft of Construction: «s--- LF Sq. Ft. of First Floor: Cost of Construction: $ 14?1.'`j _ Utilities: _Sewer _Septic Building Height: i ® lER/LESSEE° .. ::. z '' ,2.,' . CONTRACTOR° ,. .- . : , Name N4feeNP "T A c.Nec.4ev-4Z14 Name: ez'L S-raN Address:'lcc`1.. .( INDD ,C.N Company:�CNciiai. UN,..(--JC. City:' o(2 -'Sq coxa€`,. I: State: El Address:54,TS Ni-. ,:'O.:oN:0 e.-0 Zip,Code::3 *S "L Fax: CityQom1 S'C .Cue CT State: Phone No: gl5.;---`. -- Zip Code: D4-4. 7-3 Fax: E-Mail: Phone NoStot SSS' a36d Fill in fee simple Title Holder on next page�if different E-Mail � IN ��C16AF- ,. Cdr,-,1 from the Owner listed above) State or County License —3O5O' 1 ' If value of construction is 2500 or,more,a RECORDED Notice of Commencement is required. , @ C J C©NSTRUCTI®N LIEN NF®RNATI@Nea , e o 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 represu sentation that is granting a permit will authorize the permit holder to build thesubject 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 of Commencement. 2---- 1� Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA S— IA/'�� STATE OF FLORIDA COUNTY OF `-'�-C� COUNTY OF � 1a.L__--- The forgoiinn instrument was acknowledged before me The forgoing instrument was acknowledged before me this /-day of174 , 20 F1 by this J stay of Mcsvp ,20/?by g-eI----5 P)9sh-)P (Name of person acknowledging) (Name of person acknowledging) i EVC9--"/"7"'----‘,. (Signature o Notary olic--State of Florida) (Signature of Notary Public-State of Florida ) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identifation Type of Identification Produced i ' Produced Commission No. o.� Lai , o m m i s s i o n No. PLA---:,,,,, ��P,,� o Stat o lorida-Notary Publi, N VAUGHN .....,x �° '= Commission # of 270079 of �`�=State of Florida- Notary P, - Notar P f' �'1.. Q z- M .....' _ 1I="� Cou s.' _Y Publi ���� __QC + �' ' l.4,%, r My:o mission�Ex i s. 1 REVIEWS FRONT is-'4' ` •'s eu - „ to-.=-- PLANS VEGETATION -�. 9t A�?C Q / COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW lhli:iar� �°�-m i" DATE RECEIVED DATE COMPLETED ev. 7/2014