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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPL4 FOR APPLICATION TO BE ACCEPTED Date: $/ 16/l9 S btfsiviowky. = 1111 D1 Housing Department Date: s 20l l-'I Planning and Development Services L7ff RDAlRTE Building and Code Regulation Division WORKFORCE HOUSING 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: '*n- :PROPOSE©,I�V,PRQUEMEItI LQC/ATION! #,� bn>� �,,•�,n Address: 7q O 2 3 ,peas R&aA Fk. ?,tree. r-L. 3 y9S-1 Legal Description: Lot A. A 1 cjedI I S. LaK ua al gar k U l 3 PropertyTaxlD#: Lot No. Site Plan Name: Block No. Project Name: 790ay o,m2S jkc aA Setbacks Front Back: Right Side: Left Side: )(_Mechanical _Gas Tank _Gas Piping _Shutters )( Windows/Doors X Electric ,Plumbing _ Sprinklers _ Generator X Roof Pitch Total Sq. Ft of Construction: I, 7 ©q Sq. Ft. of First Floor: I, 7o q Cost of Construction: $ I R Of 000 Utilities: —Sewer Septic Building Height: C?WNIiRILESSEE t� X' �� ,i� a {, ti "TRACTOR •� i� =`F.�i � t ik `4Y l.. i?M1}�F`4^i.� ..—i. E.c + # , 3 ��y r i .'�• Y S. _ 1 . $ry vjta r:tlu 1 .o "C.SY.. 11i1« 'Swint Name Su GI I Laz•,_ WA:4L,, tLm.,,iy 11 Name: Lurie. 11, aai' R. HumAni Fy Address:� 7n0'2 Company: City:ri¢fce State:r(. Zip Code: 3 y95-0 Fax: Phone No. Va • ci4 4- f //7 Address: City: r-4--9t er Ce Stater(. Zip Code: 3 N!?X d Fax: Phone No 172.YGc/-' 1117 E-Mail: .iesePh@S�luc;cha6i�a�.eco Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail S eS ePh @ S-Hu(I e hab4 aA-QC O State or County License f=a L/q 9 C ex e Mo L If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. Lll? E1111~T>�s�• $ ^vr1 sTtQ If INSNtT1Qfit =v'k.. DESIGNER/ENGINEER: ` V9NbAPPli a le MORTGAGE COMPANY: _ Not Applicable Name: It0knJa h0(LSP Address: L/ysl <,1.i ae,e r ga 3aysa ta>� lVA- Name: Address _G City: tat&:-' Zip: 3a 'jt C Phone (-z-l.� ) q 6q-10A, m o�mrpdwxr.wswa.so:.w nn.rmwuu,® .•� `} 34itvlaatwo`" State: Sri 1ps;¢.,�r r�v� Phone: FEE SIMPLE TITLE H({bEii;��IAppllea�i e' _BOl�lf]ING COMPANY: Not Applicable Name: Mira TT�TT `" rv^frneT`v Address: 711 '' ""`'" c3 ' a e: 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 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 vour Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORID/ LL STATE OF FLORIDA . bt COUNTY OF t CA4b COUNTY OF The forgoing ins ment as acknowledgg� before me The for 1ng ins ment w s acknowledg before me thi day off (. A,,J d 201 h by this day of 20 by O'abol Rdb&+• -D, (IINI1nna11IIm/e'' of person acknowledging) NU4lYW�AN r' (Name of person acknowledging) (Signature of Notary Public -State of Florida) (Signature o Notary Public -State of Florida ) Personally Known OR Produced Identification Personally Known �` OR Produced Identification Type of Identification Type of Identification YP Produced ,o�' i. Notary Public State of Florida �'- ; �eRna-Lea Askman Produced o 'Ki Notary Public State of Florida .rye My Commission GG 174054 Commission No. �� r I Expires 15g%fP22 _ na Lea Askman ' I �c 'o My om'[ryry Sion GG 174054 Commission No. (7`1 0 4o'Nf Exp�§e01 912022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED , DATE COMPLETED Rev. 7/ZU14