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HomeMy WebLinkAboutBuilding Permit Applicaiton All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / ,, Date: S-- )')'0-- Permit Number: 1 -1(� ol p co 1 r- F L CO R 1 13 .: - MA ,_ Building Permit Application y�v2o�g. Planning t and Code Regulation Division ,<c D„o d Buildinge �nl�'n 2300 Virginia Avenue, Fort Pierce FL 34982 nfy Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: PROPOSED IMPROVg .1N LOCA IONE f Address: CI\ C' L L QA O a(LF S* ft3O -( l Legal Description: S F e, i i h L. A-Ka Is R 11.1�rcsao,3"l I L uko (c ec_, D* C-,c)-4 ct, l Property Tax ID#: JC^] �1&tom 0 owl CZ OOC)(e Lot No. CI Site Plan Name: Block No. r Project Name: Setbacks Front Back: Right Side: Left Side: DMI LED DEQ-CRIPTIQ ;tl 0 D K° % . ' °4 -'; . Pq./A-- ( o s-1--, c . TN 5- N• L Nj Q I,., @ONSTRUCTION.INFORMATIONo . Additions work to be performe• 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: r 00 Sq. Ft. of First Floor: Cost of Construction:$ ee 1-1 C Utilities: _Sewer _Septic Building Height: 6 01NN�ER,*/iLE�5EE: ;ONTR i CTOR° Name C o 1'.3 Cm I1!\i' OCL i(L ii , Name: Rit1 Address: 91 Ccvl' X90 Qs® Company: 14".)eis-i 4j/\Q:..,Q 0Por-; r City: ©r/t S4- LO C v0 State:P f4 Address: 12(do2 Sic' C'l-�, t(Pk"44-v- Zip Code: '7,Ck Ci C52- Fax: City: 2e,n,-1- S-F- t V Q.kl State: r 1A--- Phone No. o2_ 3 J 7 Zip Code: .t-t'eI 'j? Fax: t‘..)/4 E-Mail: • Phone No T<'19 L S IZ-2 I Fill in fee simple Title Holder on next page( if different E-Mail Rk (: 4 U - L&_)+2.4 Utl,✓k a- i ./4' ) from the Owner listed above) State or County License A 4 I I If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. -- x.`. _ n . SU',OL@M@NTal CtINSTR+UCT OG A11M.LAW I'NFORMATIOit ` - : -. . ' 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 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. YAL ,"(-'1S k&C,_,_ „4/2„,,,,,,,, eA.,„„ __ Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA ;.STATE OF FLORIDA COUNTY OF -� Lam_ .; COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 0_..Qay of -4Y1rii____ ,203y this day of , 20by CACAJID {TA Nk Q Name f person making statement. Name of person making statement. Personally Known OR Produced Identificat'•• Personally Known OR Produced Identification Type of IdentificationType of Identification Produced j.. 7il Produced . . N VAUGHN (Sig A/.-7;t� J kSa�tib1 .t�4 6Ims1Sl. l (Signature of Notary Public-State of Florida ) f= ,lig e: Commission n Expires misgio 2022 Com `I'9-' `'rt . MV •o ober'22�,_t,..—. rl)' Commission No. (Seal) , ' • !a ,"nus REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE N. COUNTER REVIEW - REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 8/2/17