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HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ` (262© Permit Number: j - 4 Building Permit Application Planning and Development Services Building and Cade Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMITTYPE: P4 (-40!r- PROPOSED IMPROVEMENT LOCATION: Address: -I 10O 1p� wa40 Y-1A'j•2.. ( (+ FL r PropertyTax ID ##:i �jQ� " �jZ ' 015 Ina 000 Lot No. _I Site Plan Name.Block No. Project Name: n W 1 A'YhS DETAILED DESCRIPTION OF WORK: ..Q t►noy� 1 S �i a4 CQ C� M o�kfLS'� ak '(0 C '� (-Ma:1 10 m d'e, U �1 '} 0 q M-(I'1+ rxyk'IIS} 66 o �_ CONSTRUCTION INFORMATION: Additional work to be performed under this permit- check all that apply: Mechanical _ Gas Tank _ Gas Piping _ ShuttersT Windo+w�s/Droors � Electric _ Plumbing Sprinklers —Generator <Roof J f Bitch Total Sq. Ft of Construction: 17• y I 5q. Ft_ of First Floor: 2. LIyq Cost of Construction: $ Utilities: i Sewer e Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name: �7 -- Company: C.O dig 9" ih�0_Vt'Y_S . I r1C- t Name w 1 WaADLIIs Address: 2-2-0 . hle .w 6n JI w � ''�Ie -� Address: y [ 5• IO�t� Y . City: PLY',Q0u. Wr State: f�C, Zip Code: Fax: City: S�1.1f3lc* Stater Phone No.-l-1 L- q_7 -3 2A(ag Zip code: 3y9`j7[ _ Fax:-J-3 Z_ 287 -pA E-Mail: Phone No `12--�� X82°1 Fill in fee simple Title Holder on next Page ( if different E-Mailt"�•`1 Jc C©dQ �l?i'Q flS . C41f �a State or County License CCC-P 2. C,5-14 from the Owner listed above) 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. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: ---_- IAESIGNERjENGINEER: Not Applicable Name: MORTGAGE COMPANY: Not Applicable Name: Address: Address: City State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable Name: BONDING COMPANY:T _Not Applicable Name: Address: Address: City: City: Zip: Phone: Zip: Phone: 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 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 fallowing building permit applications are exempt from undergoing a full concurrency review: room additions, accessory structures, swimming pools, fences, wails, 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WFIF I YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCI=MFNT " ,�v.�J.J1._D' Signature of caner/ Lessee/Contractor as Agent for Owner Signatur of Contractor/License Holder STATE OF FLORIPA COUNTY OF STATE OF FLORIDA COUNTY OF�� _ The for gging instrument was acknowledged before me this fl day of It --A 2f}� by The forgoing instrument was acknowledged before me this day ofLAM , 26'W b Y —r 4 Name of person making statement. Name of person making statement, Personally Known V OR Produced Identification Personally Known OR Produced Identification Type of Identificatiod Type of Identification Produced Produced (Signa t e of Nota ic- State of Florida) (Si atu e of Notar Public- State o mrrnSeal Corn No.(Seal) L 3 KEGAN CRAWFOR Cammi son Na. S I ).()MNIISSIau M e c 2�ti �_&0 FIXIIMES. (Uti bor 01, 20 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ,�v.�J.J1._D'