HomeMy WebLinkAboutBuilding Permit Applicaiton , , I
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ALL APPUCABLE INFO MUST BE COMPLETED FOR APPUCATION TO BE ACCEPTED ,
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Date: Z-5 — 2.O\q Permit Number: totn- ut) ( --,,
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RECEIVE0
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Building Permit Application MAR 05 2018
Planning and Development Services
Permitting Departmerr
Building and Code Regulation Division St. Lucie
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2300 Virginia Avenue,Fort Pierce FL 34982 .
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential •
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PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: .„. _ lo II 55 It_nneri dm.Vnik- 9,-er ce i V-Li '4951
Legal Descriptiolo ?)LI 3 --k- r-Al VW-4- 0 . te,C, 0,5 5\xott)ta. %f of 780-1 ?31 berloi
\o ' (.o1-1 Melrn en v a 5\-%,e4 ( J\L O CO-f 51).(o.V6 nc-517 26b9
Property Tax.ID#:I- CA0--tC)1-OU 22--000'(0 Lot No. 6 1
Site Plan Name:b PO% t)\1 1 C`Al--et CA tr Vale - Block No.60
-Project Name: 5 pa V\i 511 1 ciVe3 -V--e-cirtAi
Setbacks Front " Back: Right Side:: . Left Side:
DETAILED DESCRIPTION OF WORK: . - • '
.2-ras -(‘ t I kircsi-It a v\ c.,'BS h o -e...,
CONSTRUCTION INFORMATION:
Additional work to b ertormed under this permit-check all- t apply: 1
• ', E
DHVAC Gas Tank IThas Piping I Shutters ID Windows/Doors
DElectric El Plumbing OSprinkiers IEJ Generator 0 Roof
Total Sq.Ft of Construction: I COO Sevai of First Floor:ASSA ,
Cost of Construction:$ 11 ,0b0 Utilities:Li Sewer El Septic Building Height: S'i
OWNER/LESSEE: , CONTRACTOR-
Name It&rein 90 I Icii-rd-FAA c11(161( Name: A fertig ,ta 11 Crie4--
Address:1pt46S A ronev\AY-0‘ Company: /4 f kt_ ..- y Cc vit.-Fe- 1,4-
City: Fal4 D i erce., I State:a Address: a CV3Erfer rc /.&-
Zip Code: 3U q 82 Fax: )1W City: Ft tcr,--e- State: Arc-
Phone No.17 2 7(.1 Zr 2311 Zip Code:4.3 Leg/5).- - Fax: 7 7 01--9-‘6'IFF17
E-Mail:N n 1 Phone No. ) 7?---q •/- P. '
Fill in fee simple Tide Holder on next page(if different E-Mail: /( 4 IA_ CCeg/44e-17 M'C'tf 9e-QC I.C.D14-/
from the Owner listed above) State or Countiticense:
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If value of construction is$250 or more,a RECORDED Notice of Commencement is required.
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DESIGNS• ENGINEER: Not Applicable MORTGAGE COMPANY: —Not Applicable
Name: • Name: - •
Ate: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER:- ' Not Applicable BONDING COMPANY: • Not Applicable
Name: - Name: .• - -
Address: _ -- - - - A. Address: • •
. .
Zip: • . Phone: Zp: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit - •
whichSt Lucie inncconuict makesnty no aappn�Homee Othat wnersgranting
A oarules,will ty�or and coventhe permit anot may r proMit lden°build the subject such •
structure.Please consult w ►.your Home Owners Ammon and review your deed for any mons 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 appy plans,the Florida Building Codes and St.Lode County Amendments
Thefollowingbading permit applications are exempt from undergoing full concurrency review:room additions„ 1
. accessory structures,swimming pools,fences,walls,signs,screenroomiand accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result In you ovaying 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
comm• • i7 g work or recordin ur Notice of CommeneeMent
- _ALlat ,' ..i V - ft"- .,2 .444 z..)>/•=1---
Signature of Owner/Agent/ -="f` • Y,_, , , - ofContractfls ,.- • Holden' -
• STATE OF FLORIDA /W.
� ,� STATE FLORIDA 'l,/ vi9e
COUNTY OF .S W. C i4 Cf COUNTY OF 1
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The forgoing instrument was admcwledged before-me . Thewas adato e d before me
thls�.day of PA'14-P--_ ,20 14 by -. . . this .01\-A-(2— .m.4 by • -
. i4 Poc/ C
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ftC(k
<sorn adcnowIe ing) (Name of person admovAedging) l •
(Signature of Notary , , -State of Florida) (Signature of Notary State of FlOrida) •
•
Personally Knowe - OR Produ Personally Known OR identification
Type of(dentifIcation Produced F-(_ t) Type of Identification Produced t �-./J� __,
•mission Na -
' Commission Na ,,,,�,,,,, '-,r - - ,IIIIF _ ... . .-
41, ELLEN °% 1.,,, N - -o�P °ate," VAUGHbJycI :f% tateotFondaNt 'Jo . 1C
.. _ �,;i;.o,, _. ion #GG 2700
"� , P°:' My Commission Expires "'%'Eo.,,nr. My Commissiori Expire
"SOF F10�\\ ;:l/1111'�`
Revised07/15/2014 ""'" October 22 2022 . - Octotier 22 2022
REVIEWS • FRONT ZONING SUPERVISOR • PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE -
COMPLETE
INtTIAIS - . - . -
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