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HomeMy WebLinkAboutBuilding Permit Application a • ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: -'s \3\�1 Permit Number: RECEIVI'l i4AR 03 2017 Building Permit Application 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 P'R3_,P�OS.E[�i w ® MRN LOCt?tU Address: 4YD_Doi Rojeeo (-1'6neS Qccle, C-E Pi'e.rce, FL 3N i51 Legal Description: Nz,l P,neS 5qM(MOLD Property Tax ID#: 50 a'D1 a1-0QQ)-9 Lot No. 5'4 q Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: ©'E Ad!LED DESCRIIPTI�N C}F W'ORK `x _ . Now 001'�"'*' �o\a...� E�eCr-�-r-►c% 1�� 5�j stem `3e�� 1�� CON�Sl'R�U'CTIC�3 IfVFOFt�lUI� TI.®'N: y �� Additional work to e e orme under this permit-check a apply: 11HVAC Ei Gas Tank []Gas Piping _Shutters a Windows/Doors 1-1 Electric ❑ Plumbing OSprinklers ❑Generator ❑ Roof Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ 1�5,t-}-1( , Utilities: _Sewer[]Septic Building Height: e 'f `,ER, ESSEE; nCONTwRACTOR: P? , Name �'a`1(� Mc_Da.nne� Name: Robert Zrallack Address: LA 60a Poz-, Ql oeS v rc1e- Company: Solar Energy Systems City: State: Address: 160 Smallwood Avenue Zip Code: -54 GS I Fax: City: Fort Pierce State: FI Phone No. 510-9 350-Ioc-(-1 I Zip Code: 34982 Fax: 772-466-7937 E-Mail: Phone No. 772-464-2663 Fill in fee simple Title Holder on next page(if different E-Mail: vpsolarenergy@yahoo.com from the Owner listed above) State or County License: CVC056637/9057 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.•. 1 � - t S`IJ"PPLENt�rTAI.CONS�TR�U.`Ci ICON tIN LAjW t:NOR' ATION0_ 141111 �,. �,•r-,i DESIGNER/ENGINEER: _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: 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. s gnature of Owner essee/Agent Signature of Contra License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF SA-_ L cUe_ COUNTY OF -2>b CKk6e__ The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this, day of 20 n-by this \kxrday of bt�ee� 20 k7 by Robert Zrallck 1 Robert Zrallack (Name of person acknowledging) (Name of person acknowledging) (Sig ature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known_ Z OR Produced Identification Personally Known�V"' OR Produced Identification Type of Identification Produced MadeS�f�$ic Type of Identification Produced NOTARY PUBLIC Commission No.�7f(q(2/3r7 STATE OF FLORI Ptommission No.6��I a k3-7 e STATE OF FLORIDA Comm#FF912137 Comm*FF912137 %- 61). Expires 8/24/20'9 u Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS EGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW R FJJ I J REVIEW REVIEW REVIEW DATE COMPLETE INITIALS