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HomeMy WebLinkAboutBuidling PermitALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fan Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IM PRO VEM ENT LOCATION Address: Q3c3 c c\ot \\ç\ -q03 Legal Description: \ c3 Property Tax ID st: \L\1ç- -Y-ç ()0(o \ -({yT) ) Lot No. Site Plan Name: \( (\ V- I tQ)t'O\.5 Block No. Project Name: t C")'t'-ñ\ S Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK çüVLco 3iy OQ&i- 2ui9\ Lu ---- CIO` \i1* \o\V 3\Gv\ kxX4' O\-oC 4Lnt •P\(8u4ifl—. \31O ©_ CONSTRUCTION INFORMATION Acl,ditifirrial work to be AC L__.. pertormed under Gas Tank this permit -check all Gas Piping that -Shutters apply: Windows/Doors ctric r 1:1 Plumbing Sprinklers Generator Roof Roof pitch Total Sq. Ft of Construction: Sq. Ft of First Floor: Cost of Construction: $ (kçj c7(3() Utilities: LIII Sewer []Septic Building Height: WW.fsIR/LESSEE:J CONTRACTOR:' Name \(n n Name: '5ze tEl) cC arSir Address: ¼ Sfl A \¼' lit Prt Company: 1;-ICfli7icui1 -& !Jook Mc City: C- tkfQp StateE{ Address: SCOI huJ4 ST)CLQsF Zip Code: 34:I '-k61 Fax: City: A/i (i S P StatejC'( Phone No. (fl3 L{qL(_ ) )L( g Zip Code:33 - Y Fax: E-Mail: Phone No. çSLl -j Fill in fee simple Title Holder on next page if different E-Mail: )<IoS4JI A°3 Gil- c 4' ("j COit from the Owner listed above) State or County License: C1111bOS'3 gj If value of construction is $2500 or more, a RECORDED Notice of Co' mencement is required. Nam R (Name of p,prsqn acknowledgin erson acknowledging) tsonally Know Type of Id Pe .nally Known pe of Identificat ure of No Ii c- S ate of Florida (Sig Commission No. Com miss (Seal) Revised 07/15/2014 DESIGNER/ENGINEER: - Not Applicable MORTGAGE COMPANY: Name: Not Applicable Name: - Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: Name: Not Applicable BONDING COMPANY: Name: Applicable _Not Address: Address: City: - City: Zip: Phone: Zip: Phone: 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 Rome 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 NE Your failure to Record a Notice of Commencement may result in your paying twice for improvements to yot9 property. A Notice of Commencement must be reco ded and posted on the jobsite before the first S . Øction. If you intend to obtain financing, consult wjh. - nder or an attorney before cornmen or or recording your Notice of Commencem Sign .ture a Ow', - r/Lessee/contractor as Agent for Owner Si:- :tie .J' ontractor icense Holder STATE OF FLORIDA COUNTY OF STATE OF FLO 1D COUNTY OF The forgoing instrument was cknowledgeq,4efore me thiCay of Y?J3L1fJ1J iC 20 1.1iby The forgoing instrument was acl5howledged b fore me thi9yay of f)51,tMJPP/'T20 I by REVIEWS FRONT COUNTER ZONING REVIEW SUPERVISOR REVIEW PLANS REVIEW VEGETATION REVIEW SEA TURTLE REVIEW MANGROVE REVIEW DATE COMPLETE INITIALS