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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Numb .R E, �5S� L�sl d� :, n Building ermit Applicati JUL. 7 %� �3 Planning and Development Services Building and Code Regulation Division Permitting Dewar-Irrient 2300 Virginia Avenue, Fort Pierce FL 34982 Sir, Lu de C n u n ty, FL Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial R PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PRQP05ED IMPROVEMENT LOCATION Address: / $ 3 2 JAIA7-Fk.5 1V,6 4,04 y AM7- PIekC5 iFL �3 Y Legal Description: Property Tax ID #: 2- 5--32 - So ® - 0 0 3 -0 oc, _ % Lot No.. Site Plan Name: O/V 6 Block No. Project Name: 4/1,0 — J/C ( I Setbacks Front /0 Back: Right Side: �_ Left Side: D.ETAILED,DESCRIPTION OF WORK:' Cc�NSTOZ.�G t�/ZJk off' �4 SJ�i/C L£ �/4yhJLzi /fc��l��C.� BF�/coD/!?5 S 9M 13 9TH Z 571v,e / S 4230 r/ic ��12�4� FLop� CONSTRUCTION INFORMATION. - Additional work tobe e orme under t is permit —check a apply: ZHVAC LZ`J Gas Tank ®Gas Piping Shutters _ Windows/Doors rvi Electric ® Plumbing I ^I Sprinklers Generator ® Roof Z2 Roof pitch Total Sq. Ft of Construction: S" c� Co 2 S . Ft. of First Floor: look Cost of Construction: $ % ©©a O O © Utilities: Sewer Septic Building Height: :31 o" rL•1,# OWNER/LESSE'E. CONTRACTOR: Name /'i )q)Q)() 4REU CC_ Name: /% A)el0 Ak S 00- 0i Address: Z-3 /1/6 /413,4C14 •fiVA Company: Cp L Cv $11c Q-7a4oA/D A? 41 City: k/e&S. 'Al 47eXe11 State:, Address: 23vr/S/E ABA!C Jj� Zip Code: � 91 S7 Fax: City: ,%�.t/S��/ BFAd)� State:_2� Phone No. 772 2 6 0 — 7. f'/ Zip Code: g S% Fax: E-Mail: 1YV4RBVC,0_%QCOid'JC%i����/ Phone No. 77Z ZU? ZaZ3 E-Mail: /V)JA123 UCC. / cQ co /YIC,i o /,i(! Fill in fee simple Title Holder on next page-( if different from the Owner listed above) State or County License: 00-44 01 3.1_3 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. I V ,SUiPPLEMENTAL CONSTRUCTfON,LIEN LAW INFORMATION" ;;. DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable Name: JAfnF-5 O&SNot, 6,1 ' , ltVC Name: Address: 3300 AW /o'er' TiiZ/2_' 0 02 Y Address: City: RDA_P0AA10 Rgs j� State: FL City: State: Zip: 3_304,Y Phonet?;5'9 9:56, 22 0-3 Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: X Not Applicable Name: Name: Address: Ad d ress: 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 yo r property. A Notice of Commencement must be recorded and posted on the jobsite before the fi insp ction. If you intend to obtain financing, consult w th le} er or an attorney before commenci or or recording vour Notice of Commencement. , V� Signature of Owner/ Lessee/Contractor as Agent f /�{�{.y''�Wg Sign AGre oT Contractor/License Holder STATE OF FLORIDA STATE OF FLORI W h_ COUNTY OF m .. COUNTY OF a LL� The fgraping instr ent was acknowledg efore 8 $ � day 20 by ? The forPoing instr this 17 day of t was acknowledggd�efore 20'_o by �_nCr �a this of $ g 6/ E yew -b Name of perso aking statement. W Name of pers making statement Personally Known OR Produced Identificatio �;;;;.' Personally Known OR Produced Identificatio =' Type of Identification Type of Identification • "�� Produced Produced ..mr. cj�r �t . - (Signature of Nota ublic- State of Florida U (Signature of Notary blic- State of Florida) i Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED 1 DATE COMPLETED Rev. 8/2/17