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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: l (� _ RECEIVED Building Permit Application MAR / 201� 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 PROPOSE® liltill�PR®�UEMiENTLOCATION �`µ l �A rB .E '_ �- Address: aaHO Legal Description: Wi++ G 5(p 03- 7E 4k, w lov . L ss ryd ZG g G',a G n a lz b j-/w in r h o rL :95ie�Z3 14� PropertyTax ID#: 14o?- 57-2--016.3—cxx3/­�- Lot No. Site Plan Name: Cz�.c�4- �-��- Block No. Project-Name: Setbacks Front Back: Right Side: Left Side: ©ETA VED ®ESCRI,PT�,IONkO`F�WOR?K ti ti ,�,,��,�c- �5t,i►�I-P-J $ f--is15�I � ��ar� +'U o'y"� r�-l-G�, al ice, `O , S�TIR,l1C�TiON 1'N F®R{I�l1TlN r_' .;W t. t Additional work to be pertormed under this permit-c ec k all that apply: _HVAC _Gas Tank —Gas Piping _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator Roof Roof pitch Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ Z6LO- Utilities: —Sewer _Septic I Building Height: •W� 9 .... to £ �€ _�, #t� N^ a r� ,�• 5� - � �` , QWNEftILEaSHSEE: ;.4z °,< }, *CONTRACTVA OR# ubt h . Name NA h Name: Address: a`lY0 (J h'i�y.rurt l(L� Company: L1_4_k�✓csaF,n� City: ���� iPi��- State: et. Address: YI Z- sC L,n cam►M Y,7vr- Zip Code: 34 9 tJ Fax: — City: 5kt�-V'►— State:A,"L Phone No. Zip Code: )AT, 4 Fax: E-Mail: Phone No. 'Rz_ Q0 > I Fill in fee simple Title Holder on next page(if different E-Mail: eA1 Vc,6- from the Owner listed above) State or County License: Cc— 3 3 037--7- If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SU�PPL'EM'ErNTAL CO,NSTRU.CTION LIEN LAW INFORMATION: .,, �.r. ,,,; 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 Ignature of 0 er Lessee/Contractor as Agent for Owner S' nature of nt cense Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 016,47,1 COUNTY OF 0qr, r-" The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this X day of WLg--w 20 Lby this day of Y"N�L- 120 1 �)- by (Name of pers acknowledging) (Name of per on acknowledging) (Signature of No ary Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification Personally Known X:�) OR Produced Identification Type of Identificati nd Produced Type of Identification Produced Commission No. M _ Co mission No. (Seal) ,2o�reY'e�ac. THERESADERITA ,<>eY:P2e. THERCSADERITA AAYc n *FP ris2w., o.• •.�_. EXPIRES:October 29,2017 ="c -;,, *_ MMISSION k FF 062929 =: P = - EXPIRES:October29.2.017 Revised 07/15/2014 Bonded Thru Notary Public Undernriters �?z -;,oF„Fa` Bonded Thru Notary Public Underwriter REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS