HomeMy WebLinkAboutBuilding Permit Application s
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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED c�
Date: Permit Number:
BuildingRECEIVED
Permit Application Aug
pp � 9 �ot9 �.
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential I�
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
�PROPOSLaIIVIPROElUIE7T` OCAT�QN4� .'�'i, 1 ..� ,¢ , T�a yr � f
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' Address: 1 _5 OC.0r,n Dc 513
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Legal Description: QC40_,e-,r,
Property Tax ID#: i a1" ;Ina-not R'G(Din Lot No.
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Site Plan Name: Block No.
Project Name:_�_U r-6 S
Setbacks Front Back: Right Side: Left Side:
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Additionalwork to be erformed under this permit—check a appy: I
HVAC Gas Tank ❑Gas Piping _Shutters ElWindows/Doors
Electric Plumbing Sprinklers E]Generator U Roof '
Total Sq. Ft of Construction: S . Ft.of First Floor: }
Cost of Construction:$ j 7 �- Utilities: Sewer 11 Septic Building Height:
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Name_Kuc ctS Pe—n-WeC.l_7C. Name:-.3c-L)3 _16-1--k:I , S-tee
Address:S l L73 ( e` scam► Oct Company: 14,G) Qoj
City:Pdr t ck-c i o 4-c State:'9 L Address: i s(Q 1 '75,Tf-I 011- ti>
Zip Code:23 Cl q Fax: City: 1,� vtic t~�C'��� State:
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`-t 1Zip Code:3sL'I1 Fax: �:i_C:1
E-Mail: 7 ce Ooyviea_s '. P,,1 Phone No. r Cj5y
Fill in fee simple Title Holder on next page(if different E-Mail: Ce lwA'jeer Q •C GYM
from the Owner listed above) State or County License: L 6 C 1-�i 3
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER ENGINEER:
/ Not A licable
PP MORTGAGE COMPANY: Not A PP licable :#
Name: Name:
Address:
Address: s
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City: State: City: State: I
Zip: Phone: Zip: Phone:
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FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable F
Name:
Name: .w
Address: Address:
City: City: II
Zip: Phone: Zip: Phone:
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I certify that no work or installation has commenced prior to the issuance of a permit. s
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, 1
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 fipFt inspection. If you intend to obtain financing, consult with lender or an attorney before
commoncinA Work or recording our Notice of Commencement. !
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Signature of Owner/Lessee/Agent ature of Contractor/License Holder
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STATE OF FLO DA STATE OF FLO A
COUNTY OF. �- 4t' COUNTY OF
The forging instrument was acknowledged before me The forgoing instrument was ac nowledged before me
this ' qday of Z-o4l 20 J! by this a�`7 day of fi�QS 20 by 1
(Name of person acknowledging) (Name of person acknowledging)
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ignature of Nofary Public-State of Florida) (Signatu of Notary ic-Stat f Florida) ;
Personally Known lY OR Produced (den'fification " Personally Known OR Produced Identification
Type of Identification Produced if ation Produced
1' PAULA WILMAN
Commission No.(�(r i190Q 3/ pl ;�, MYCOMMIS �i9 d N Pmpli"^ 4ftayOUNG
EXPIRES: U1}g2Jr�2022 �r„ * MY COMMISSION Y.FF 951069 _t
EXPIRES:ADd 12.2620 `
plc'pr-�04� Sond.d Thou 3uCoot Novy SorAces
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE `
INITIALS
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