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HomeMy WebLinkAboutBuilding permitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: "2.y Permit Number: ouillaing rermn Appucatilon Planning one Development Services Building and Code .Regutotion Division 2300 Virglnio Avenue, Fort Pierce Ft 34982 ; Phone: (772) 462-1553 Fax: (772) 462-=578 Commercial Residential PEKMI I APPLIC;A I IUN FUR: To Select from dropbox, click arrow at the end of line -i'HUt'US)=U iMi'KUV1=M1=N 1 LUCAiION: ---- - ------ - - _ ---- Address: ?/vi 11 in k`2 Q� Legal Description,: Property Tax ID #: 33 a 1 — ! 0 2 — 0009 ^ UU©" & Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DE I AILED UESC:KIP I ION UE WORK: CONSTRUCTION INFORMATION: Additi T work toe Qe -6rformed urider this permit check aTi t� apply: rHVAC I ] Gas Tank ❑Gas Piping LJ Shutters 1-11 windows/Doors 01 Electric Plumbing Sprinklers Generator 10 Roof Roof pitch Total Sq. Ft of Construction.: � � � J Sq. Ft. of First Floor: Cost of Construction: $ Utiiities: Sewer Septic Building Height: OWNER/LESSEE: CONTRACTOR. -- - - NameF�n�SE %UL2 ��EC'�f?nf'7L'r 1 Name: CUtcT1 ,SF}rLtyr. Address: 8/61u L n Lc7, c-J6' L4, ,! Company: 6L —r6 ni S City: State: ��, j Address: 1 �7'I5 'S E �/l [I etQ-4e ( r e(f r't Zip Code:L3LI9 �(O Fax: ; City: �� i St L uc.{ f_ State: r-t- Phone No. i " 51-)5 or334 i Zip Code: 45.2 - Fax: 7%?- 3 3 5-1 9 is E-Mail: Phone No. T1,L 33 5- ` 3 2 3 1 I Fill in fee simple Title Holder on next page ( if different E-Mail: id 3 t c� t r S ti s £ Cc o • C [ �01 from the Owner listed above) State or County License: G G' S ( F (0 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEM EN I AL CONS I RUC I ION LIEN LAW i NFORMA 1 ION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: 1 Zip: Phone: i FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zap: Phone: I certify that no work or installation has commenced prior to the issuance of a perm it- St- Lucie County makes no representation that is granting a permit rill authorize the permit holder to build the subject structure �-.hich is in conflict with any applicable Home Ciwners Association rules, b%aar!s or and covenants that may restrict or prohibit such structure_ Please consult vAth your Home Owners Association and review ;tour deed for any restrictions vehlch may apply. In consideration of the granting of this requested permit, I do hereby agree that I Neill, in all respects, perform the Work in accordance Ath the approved plans, the Florida Building Codes and St- Lucie County Amendments. The follmkiing building permit applications are exen;ptfrom undergoing a full concurency review: room additions, accessory structures, sLvrmnring pools, fences, wa.ls, 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 ,'our Notice or Commencement. Signature of Owner/.essee,'Contracior as Agent for O.vner Signature of Contracor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF — I The forgoing instrument was acknowledged efore me � bv The forgoing instrument teas acknov.lodged before n.e this day 20 by this: day of _ 20 I of (Name of person acknc�.ledging) ( 'Name of person acknov.,ledging ) (Signature of Notary Public- Stet_ :.f Pc a) (51gnature of Notary Public- State o Iorlc; .-_ Personally Kno).vn OR Produced Identification Personally Known OR Produced Identification Type of identification Produced Type of identification Produced / r'^ ;,.`?, ! - q CHRISTINEBENQMfiimission Commission No- .� .; : _ _ * * MYCOMMiSSIONB No. _ — G052546 ----- ty�� EXPIREs %crap .2021- —�z ---eHR 4t ---- e�1ea Ea etl7twBudg°tK RetisedGZi1S12GI Y ,.••-. BENGLISH *FC MYCOMMISSiONtGG052548 �zT EXPIRES: W 4, 2021 REVIEWS i FRONT ZONING SUPERVISOR i PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW I REViEVb' REVIEW DATE - I COMPLETE I ! N IT! ALS iS14 032 o )21 3