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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED \-9-'05- Date: ' 16 —A.n `c 1 Permit Number: 05 1313 7 RECEIVED CQ&J F L a R I CO e MAR1 � 1018 Building Permit Application Planning and Development Services. Permitting Department Building and Code Regulation Division St.Lucie County 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X PERMIT APPLICATION FOR: PRQPoSED-E1NPROVEMC 'OCATIQNE , ' ; ' '° • . Address: \ 6 2 13 k.4-c7( Q 'Oil . C. P 12-(pr 345 5 Z Legal Description: L.( k..5 IC S lit {-' SP.-..J A-N a-IN C 0010 �LIC 3S i# 44 Property Tax ID#: 3 oZ5 7()7�t ) In 7 f Lot No. 7'C Site Plan Name: Block No. 35 Project Name: Setbacks Front Back: Right Side: Left Side: '-DEVAIL@DDMORIPTIO CP WORK° �g ,$ e sn ., J ,. Y x mEAr 't--k f SA- Cc cD 4-v- J 7 s 4- ( ( p (2-4- ( N 5i1C sk I ,5 LT -S k QC, 1 OC) l-w 0 OA ` N t ? CI w vc1–"4 r a–ic0 1 �J ( 1r CONSTRUCTIO INFOR ATIONo I. , :A ti 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 7 Pitch Total Sq. Ft of Construction: Cgff ' Sq. Ft.of First Floor: • Cost of Construction: $ 'S(t 35 e:. Utilities: _Sewer _Septic Building Height: 0 ER/LEStiSEEo :-. ::. ,vp . ° :, €ON TORa'. ;:: , :.4. : .e TRAC .,. ��� .t. o Name M As r i Q 4 \ NI A-CA ` \ Name: C/,.e3-4. - A 6._es-L-A--- Address: ( 2 r?›+4"-- k-1-0 t a. M Company. dA-v'p `k 1-t--..0 D -C Q f City: , S �lP State: (o(0 2 '-& Co-'th si •-,- "L. �fa 2. �,.. -( � ��'Address: _ .. 2 ZipCode:• 5 2 .:.~:Fax: City: Pe7 E .._,.., ...... ...State:Pki, , Phone No. 2'6 Co 2- -lam Zip Code: 3'E 52 Fax: E-Mail: Phone No 7 (-(52_ \ Fill in fee simple Title Holder on next page( if different E-Mail rl r L %,2_ c..-/ -k-•r- rk-r L.. v)- Ci. GI' £' -4' from the Owner listed above) State or County License L 4 1 o 7 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. , i SUPPLEM 1t CQNSTREUCTI®N aM ONFORMATI©Ng ' / - - A MORTGAGE COMPANY: DESIGNER ENGINEER: Not Applicable _ 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' ermit I do hereby agree that I will,in all respects,s, 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 reco ding your Notice of Commencement. ... ' —ec' d'LL--..._____ i Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDASTATE OF FLORIDA COUNTY OF S k' ,C/L12_ - COUNTY OF Sl"Wk, The forgoing instrument w s knowledged before me The for oing instrument��was acknowledged before me f i this cday of /� , 2011 by this I i�day of Y 41 t _ , 20 (/ by ? e,N,ybiD Tr-g��,U\L ibt-Gtvw-Trow-voe- Name of person making statement. - Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identifica ionType of Identifica Produced r \n Produced P t EucLur...._,- -Notary ✓ V C(Signature of Notary Putate of Florida) (Signature of Nota StateofFloridarY )�`1414 ' ELLEN VAIQ51II� .,e - ,; ECommission . oa, ot+Yd�,Commission No. -ELLE �:Z eHN M ')��ui o:Stale of Florida-Notary,Public _, ,,;,';= tateof Florida—��'= Commission #GG 270079 -�a� Corn Public ''N/11110 Octobe•r ' .•• " I '"714%;'P' 'Y °mmissi •, REVIEWS - .`: 22'_2c-- --2lr• RVISOR PLANS VEGE * ' ° Expir COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW " " '--,' DATE RECEIVED DATE COMPLETED ev. 8/2/17