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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMP AD FOR APPLICATION TO BE ACCEPTED Date: Permit Number: L ' •: ..� FIE, ' FE507N , Building Permit Application Planning and Development Services PERF`'•'•` ' +b• I- Building and Code Regulation Division St. Lucie -Ccvnl 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: PR@P SED 1N'PROUEMENT L®CATIO.hi: Address: `03J-1 c4 FJ-rL-Es (3 Ly CN i Fr�s� �{�,; S-� Legal Description: c.IE%rr r�cS St cJi� Le�rJ� SSG-r�mc�J \L <?tA2cF-L\43�A' n�D pczr SZf :q 52� C� -di��of� -L .MfcN�� �02 3000 - a5^1� Property Tax ID#: I-i Sr,2�k, - ,So k - \ \r no c, 3 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION aF 1A/®RK: 20 o k=o\r _S-t r7 cJ A Mgl3k-�E Ogl ynR CO'NSTR�UCTION I.NFORMATItJN: Mow.W Additional work to be pertormed under this permit-check all that app y: Mechanical' _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers =Generator Roof Total Sq, Ft of Construction: `ova Sq. Ft.of First Floor: Cost of Construction:$ '�`�«� -o o Utilities: —Sewer —Septic Building Height: OUI/NER/LE�S�SEE: C�ONTRA(;TOR: Name (r1rr\A cJ 0A 'Kcz)2-'T-CZoyo1-<-\S Name:.... Address: Company: City: 'IFAs-r la.�:r a F� State: Address: z-E St , cL--k"� s-ti Zip Code: 1�a 5a. Fax: City: 0 s r`CJAN o a;s4g-;A State: Phone No. 7 k C,, �$9 - &G \Cs Zip Code: 3.3 Cx6 l Fax: 0R,9 E-Mail: Phone No Fill in fee simple Title Holder on next page (if different E-Mail 6-1r S c%F rL=A ._C-oL\ from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. I� SIJPPLEM �(Ul'�lL.C®NSl"R+UCTI®N LI`EN LAIN IN!F©RMAT'CON: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: 'X Not Applicable Name: --"_S- vvvfs Name: Address:`Ss,_? ram. Aopztws. Address: City: Qom,W"pnN o State: T�z__ City: State: Zip: PhoneGs+-` ciS-r-, - Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: X 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 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 der or an attorney before commencing work or recordih'`'our Notice of Commencement. Signature of Owne essee/Age ?gna�e of Coriractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 1: r W qzc� COUNTY OF CScZ a I,JA.ri® The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 3 day of 20l'� by this 3 day of F'E:Z2J y , 20 1-) by Jt�H 1�Vs�L2/��� �C714rJ .lv\Jrr?_" (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known r,� OR Produced Identification Personally Known��OR Produced Identification Type of Identification Type of Identification Produced Produced tsar aua,, �o ...,• ALAN MILLER Oar ouee, ALAN MILLER Commission Nd� «�toi (4epCOMMISSION#FF 195499 Commission No.'s-- \ciS J-\�'r� �° eA�)COMMISSION#FF 1954 EXPIRES:May 5,2019 * * EXPIRES:May 5,2019 �'+� o�\O� Bonded Thtu Budget Notary Services "r� �o` BondedThN Budget Notary Slrvk REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED , DATE �� COMPLETED ev.