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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUT BE COMPLETED FOR APPLICATION TO BE ACCEPTED i Date: �-/ �'" Permit Number: s p1. Zf , ' - er�ittin "fy' Building Permit Application`°cP°',-ort Planning and Development Services ' Building and Code Regulation Division i 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential j i PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line j IMPRa.VElii?[ENT:LOCATi'(?,N . ".'. .. :. :. .. . . : •.: ,:�: •:.::�.�.:.--_-- :«:- :-,:.:�: Address: - J _ Legal Description: f, r r�ry ._' �'t' 'u• ^, t�' Property Tax ID i -0'-)C)-'o _ Lot No. Site Plan Name: Cr, r- . r Block No. Project Name: \ � Setbacks Front Back: Right Side: Left Side: DETAILED DESCEttPTIQN, OF 4L CC3NSTRUCTIONIIIFbRMAT{QN..... : Additional wor tonGasTank orme under this permit—check a apply: HVAC ❑Gas Piping _Shutters 2Windows/Doors Electric L�Plumbing FISprinklers o Generator Roof Total Sq. Ft of Construction: Sq- Ft-of First Floor: Cost of Construction:$ ' .1 ��. ��C? Utilities: 'Sewer Septic Building Height: i owN /, l.� eo�vTl�acraR - r Name_ €- Gc r �!' t.C'r Name:.. i_:(Yze'n' Address:foo &-)x c", {., Company:, 54_ :.± Cw�r�C3G�, f - _.�.' iz- r meq'"f City: r�or-(z- (� �_� State: Address: Zip Code:'67,44 75 c-4 Fax: City: L,0 flt-_t_n- __ ti Q t'' ` State:_` fahone No.'s? -tf i_1 a i ? Zip Code:3':!L'' i :3 - Fax: �C^- t �J •`^/`L 3 E-Mail: Phone No. S'Lr-i- 5- Fill Fill in fee simple Title Holder on next page (if different E Mail: from the Owner listed above) I State or County License: 6_7 C1 if value of construction is$2500 or more,a RECORDED Notice of Commencement is required. i UPP, EM;ENTA1 �YCQNSTRUCTIQNrLIEN IAiN fNF }RIUTATitJN rr ''f <j ` iy' DESIGNERjENGINEER: T Not Applicable MORTGAGE COMPANY: ,Not Applicable Name: Name: I Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: i i FEE SIMPLE TITLE HOLDER: `Not Applicable BONDING'COMPANY: —Not Applicable Name: Name: I Address: Address: City: City: Zip: Phone: Zip: Phone: I 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 our Notice of Commencement. CTA � r s _Signatur f Owner/Lessee/Agent ature of Contractor/License Holder STATE OF FLORIDA STATE OF FLO7 DA COUNTY OF—,SA- c. A- .Lc, ; '� COUNTY OF ¢� The forgoing instrument was acknowledged before me The for oing instrument was acknowledgedkefore me this 3ca day of Sc�.a �.�, »� 20 .j ti by this day of t' 20 LJ� -by r - (Name of Oerson acknowledging) (Name of person acknowledging) Signature o N ry Public-State of Florida) {Signat of Notary P, blit-Stat f Florida) Personally Known,�rOR Produced Identification Personally Known 11/OR Produced Identification Type of Identification Produced Type of Identification Produced Commission No. Cl(- k c-(S( ) No. (Seal) Notary Public Sts of Florida 2t� pie o . , �. ANGEtAYOUNG Q My Commission GG 164314 * * MY COMMISSION#FF 951089 Revised 07115/2014 0,�� Expires 0312812022 Nyi ce EXPIRES:A0112.2020 re Hlh 0�4!'tiAdi/�,AN/1f�'�Ii4 Faptt6a` HaoQadiipu8ud et No Ser REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS