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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / t Date: / ` • 17. Permit Number: I � ! E- ENED Building Permit Application JAN 501 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 PERMIT APPLICATION FOR To Select from dropbox, click arrow at the end of line r { ,sG�;" s+ �'.x r L r Y.l 2�.„ • a s s 7 t r 6 -} n. ? °E R � -.r�,� ,.>..<,�..,1.., ,.., � ._...,:,r, .,_.�,� .r,., •��;,L"frr� :� � �.,� .�,k�,�,G;ti ti��{��� � �s,�.�, r.,._�..� ��,�.3,..hT��t.r�����r.,,���"� '�srr.�i�a����,'.{a.z �. Address: 1 1-7 007 kltp< e f mo..50L C4 „V6Lt. H S'q"$l / A Legal Description: Property Tax ID#:� ® C C?0 i Lot No. 15 Site Plan Name: ., Block No. A Project Name: �e &R5 , _- Setbacks Front l_05, Back: Zco' Right Side: Left Side: 126 xs mid b qr idY t �-r< <;�_a:.a, ,Y.t, rrr�t �a�s�a `�n..._z,., ...a.. .➢,t�'_..#`Y�.� �i �•�.,.,.�rt�.�.w!,'�`. a.,,ru<.. ..;i�,� �"�' _�.,�� x-..� ,e� � i ^sf,;_.. ...�..,�.';x?Y-�.. , ;,�i' ,u�� `k( ryyF y��E {.;.,amY 4 r CUNSTRUCTION�INFC1RIt/IATION ����� �Y �;����f,���,��,��� � ., �,��zM ,,� f� � s� , �.� �,� ,{ .3S1a� Additional wora'taa .✓. ; ...R9xxe: '� .' 1 { tJ��,,.:�'"du,xi C`. C, G: r''"Y) °.i.. i F ,�1. N ,1 ..,t nW? a w.... ,., _.._.. .. ,.... _ _ Mu.�. .a 3__�„... e Dertormed under t is permit—check all that appy: OL HVAC =.)Gas Tank Gas Piping Shutters II Windows/Doors Electric ©Plumbing Sprinklers 12Generator 1^ 1 Roof Total Sq. Ft of Construction: `=�1'� Sq. Ft.of First Floor: f Cost of Construction:$. ZJ`+a K Utilities: Sewer IKISeptic Building Height: ani ,,r "g "`��` , 'h v �"”" .ra..M a.� ""Jaw, n.{5s , .• .,NFr 'Y h.{.,5 ;n}' }i}''� '7:.:.i: 3•:�i xk i ..k`.. nyr �r rYf t :c4 :,Fr r..{A rz 4.Sbni°s �iJ'ty�Y7.:^, O,U1/NERfLES$EE , vb €)1TRACTORPwr.., , ,.�., , s t.�,� r�:u ,�zt.t? { v nixrt v¢ Name ��s4►n e S i c, e. Name: Address: 111991 k�p� 1 00--A CA Company: City: P-6 Z- State: Address: Zip Code:Ji4 91-1 Fax: City: State: Phone No. '772 ��?5i- -7 of ec NT Zip Code: Fax: E-Mail• ,3 �GZ C>-700 t�VS1t)ri-Q Phone No. Fill in fee simple Title Halder on next page(if different E-Mail: from the Owner listed above) State or County License: If value of construction is$2540 or more,a RECORDED Notice of Commencement is required. t�5 t tee. t ee. >CDccs ......... 5UP�PLENfENTAI:CONSTRUCTION LiEN LAW I1�FORMAT[ON .x•Pt ,4�,-.1�...� .,.an, "� xa�.�od,,.._w�k�. F�,:<„x&i ..F..�.,4�r���•,F ;d.dF �»;n,r vk.,�, ,>.-,�'�r..v�« kb;,1 .a'�.,xus.n,L:...�,�: r_�'�,i,,�yd i§"Sx},.,,«.r+ ..:[�',.�,�' t}�.c..�-k�,%.0��r,�t r},U DESIGNERjENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable Name: CCK W( ir��,,yzD Name: Address _ Ga �e/au,L7nrte Address: City: State: j�L_ City: State: Zip: �?*qs?Z Phone: 4(n 0- 7 7 1 Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable Name: Name: T 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 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 our Notice of Commencement. Sig a re of Owner/Agent/Lesse -• Signature of Contractor/License Holder STATE OF FLORID�4 STATE.OF FLORID_A COUNTY OF Kim COUNTY OF �cn�� The forgoing The f rgoing ins nt was acknowledged befor 2M_• g ' g instrument was ack wedged before me ti day of 20 by this day of 2014 by i a;a (Name of person acknowl dg' g} (Name ofperson now(edging) (Signature of ary Public- ate of Florid /yppe re of Notary Public-State of Florida} Personally Known R Pro c d Iden ification y Known OR Produced Identification Type of Identification Produced dentification Produced Commission No. (Seal.) Commission No. (Seal) Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REV EW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE �� I INITIALS