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HomeMy WebLinkAboutBuilding permit appxw'`�i'"' w 'wS,�`'• glum .,i �ftrY � a`� �,R r DESIGNER/ENGIN�ER: Not Applicable , MORTGAGE COMPANY: � Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Name: 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 Counttyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conitict 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 1 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. Signature of Owner/ Lessee/Contractor as Agent for Owner ignature of Contractor/License Holder STATE OF FLORID � •�' STATE OF FLORID COUNTY OF , ��lJ� E COUNTY OF �- , The forgoing instrument was acknowledged before me this dayof C)C!--DBcC 20Ze: by Name of person making statement Personaily Known OR Produced Identification Lr Type of identification Produced LoLkDA D O'yIEy kcxa&' -(signature of to Pu to of Florida r ,,,,�A N pVPxQ°i � °riaa Commission No. i�i l is � e 7ia{ 18'v" r��a'pU8[ < ,1022 �°G mm�xSExY�esFltlo dtY Pssn. 'k..i. Ml�oi. ti.tia1O� REVIEWS FRONT SUPERVISOR CORI=V UNTE IEW REVIEW DATE DATE COMPLE7 Rev. 8/2/17 The forgoing instrument was acknowledged before me this .V� day of ..QCfi©5Ct- 2020 by S Shy �1� Name of person making statement Personally Known OR Produced Identification � L Type of identification Produced °F 1 D'�_\PR E)R � xE'_ L-4 c.e.vr& Commission No. UL-i1 `¢ PLANS VEGETATION REVIEW REVIEW n ( Px e o� F�atida j�a i�'b1',c-S G�y189,00 a i5stp° ' Feb 2 ' F CQmfi .�Xp"e5 �Notiat4 MANGROVE REVIEW ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �o _ o_z u Permit Nu b m er. s Planning and Development Services Building Permit Application Building and Code Regulation Division 2300 Virginia Avenue, Fort 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 Address: 2 !2 3 L Legal Description: PropertyTaxlD#: d/-6a3- o!% P--adr� Site Plan Name: AIIX Project Name: 1,6r,ar) Setbacks Front. Back. —Right Side: Left Side: Ili! 7 Q tya`Y1/ unaertnis permit—c ec a appY- 13 [JHVAC Gas Tank ❑Gas Piping Shutters Electric Plumbing OSprinklers Generator Total Sq. Ft of Construction: S Ft. of First Floor: _ Cost of Construction: $ ° Utilities: OSewer OSeptic of Name ��o Address:�,7 City: State: tl Zip Code: Fax: Phone No. 10 E-Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) Lot No. cZ/ Block No. la— QWindows/Doors CRoof = Roof pitch Building Height: Name: o L Company: a Address: Cii`A; ' r� Stater Zip Code:g ��,�� Fax: Phone No. ?22 E-Mail: TOi'f? �s o State or County License• If value of construction is $2s00 or more, a RECORDED Notice of Commencement is required.