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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �� ®11 Date: `7myc, Permit Number: � A�_ CP h`® Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential ) ' PERMITTYPE: PRUPOSED iMPROUE�MENT LOCATION: Address: j-/� r�' ry� 1 Property Tax ID#: 3� A QQ' 0o V�vI�.J Vflf�4�J Lot No. Site Plan Name: Block No. . Project Name:—5;L/ -be- X1455, 2riq;y fACGI�s�;v� D TAIEE© DE�SCR�IPTM(W WORK: Zfeh/iqe 1 , -V-e_ J 57116 /mss ,Dom C©NSTRUCT)ON INFOR1/IAIle Additional work to be performed 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: Sq. Ft. of First Floor: _ Cost of Construction:$ ` 2.b® Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name �C" S� , Name: YC Address: ��"Z st4 iA Company: C to-1,/'L City: %�/�P Y State: Address: Soh S 'GZ� ' CYC Zip Code: �T 2 Fax: City: J� Gefcr i�— State:. Phone No. �7 fZ" S ZJ— ��Z Zip Code: Fax: 77 2- E-Mail: Phone No172 �/— Fill in fee simple Title Holder on next page(if different E-Mai1L�G�vj j S j�.2 'Z. >� �a2Jr3)Gv from the Owner listed above) State or County License. cmc. If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required. i I DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Nat Applicable 1 Name: 'Name: I Address: Address: {' City: State: City: State: I Zip: Phone Zip': Phone: I FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: . Not Applicable : I Name: Name: Address: Address: I City: City: Zip: Phone: Zip: Phone: { I 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*Horne Owners Association rules,bylaws or and covenants that may restrict or prohibit such structure.Please consult with your Horne Owners Association and review your deed.for any restrictions which may apply. In consideration of the granting of this requested permit,I do'herebyagree 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: roam additions, accessory structures,swimming pools,fences,walls,signs,screen rooms and'accessory uses to another non-residential use "WARNING TO OWNgW_Y-OUR—FAILU ER TO RECORD F, MMENCEMENT MAY RESULT IN YOUR PAYING, TWICE FOR.-IMPROVEMENTS TO OPERTY. A NOTICE ENCEMENT MUST BE RECORDED AND POST ON THE JOB S ORE THE FIRST INSPECTION. IF YOU INT OBTAIN FINANCING, CONSULT TH YOUR LENDER N W ATTORNEY BEFORE RECORDING,YOURNOTICE OF NCEMENT." Signature of Owner/Les /Contractor as Agent for.owner of -Holder "- f STATE OF FLORIDASTATE OF FLORIDA ( COUNTY OF COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledgecj,k�efore me this ° i day of _OD^� , 1 2p by thio' day of- C�(� S"` 20 Y I Name of person making statement. 4 Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced F L_ ID L, Produced c () I,, (Signature of-Ittot �euplj� State e t1g 4/ 11 G H NL[ignat ]Vot�.ru �P, ic-Std fI�F1b��4 H NState of Florida-Nater Publi ;o`°�LPP911Statey ofFlorida-Notary blitCommission No. " isslg9d69G 270079mmis "* mmission # G P079, � Co Expires m o res�� October 22, 2 i ototober 22, 2022 . REVIEWS 'FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE ' I RECEIVED DATE COMPLETED ev.