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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETE FOR APPLICATION TO BE ACCEPTED Date: 0.J 16 0 Permit Number: ��d3��56 RECEIVED MAR Z 72017 `' f P143(15 1 - -- 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 - Gi PERMIT APPLICATION FOR: sv 1k �,&VnO 1���r PR�OP©SED INP'R�0 fMENT LOCATION: Address:!515"0.K1 w`C,,,. 'ZA. !Tjasc pg. 2 Y Q T W.(I 00c)1 006- 1 Legal Description: a Property Tax ID#: Lot No. Site Plan Name: t \ Block No. Project Name: Setbacks Front �5,2,Z Back: Right Side: 6?2, Qy Left Side: DETAILED DMCRIPTION OF WORK: 3 t , L/ ��CQfpC snS `R,lV nC l"gS' - ��ifaCt CONT SUCTION 1!NFO80ATIMN: Additional work to be performed under this permit-check all that app V ¢C'Mechanical _Gas Tank _Gas Piping _Shutters WindowS/Doors Electric Plumbing Sprinklers _'Generator V. Roof 5 !Q_ Pitch Total Sq. Ft of Construction: 34?3; Sq. Ft. of First Floor: .�3 q_7 3 Cost of Construction: $ as l_000,. Utilities: _Sewer )e-Septic Building Height: /0 FL FOR N0E /LE�S�SE; �CO.NTRACTOUR: Name �' SA Q. Name:.-- Address: 25�-e k_.�v.'%7 c AA, 7RA. Company: City::E State:EL_ - :Address: Zip Code: ?q A T Fax: City: State: Phone No.�7-Z.L).,-o l 5,2 qI (72.1) 70,q-0ZL(T Zip Code: Fax: E-Mail: S I eri o. a.m Cc+,l... Phone No Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL C«ONSTRIJCTI'®N LIEN LAUV I(\L!F®RMATI®(U: r: DESIGNER/ENGINEER: ' ' ' _ Not Applicable MORTGAGE COMPANY: _Not Applicable Name: 1 k-tcl oA N Ste\ Name: Address: Address: City:'r')t State: `FI_a City: State: Zip: 3y G 5C2 Phone )— Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: 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 lender or an attorney before commencing work or recording our Notice of Commencement. e Signature of Owner/Lesse Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA / COUNTY OF S-'V• �V�e`� COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was ac ow7ed.ged before me this�day of No c 2011 by this day of _ by 4#..6.9;01 '; \ S 19k\ $ b (Name of person acknowledging) (Name of pe on acknowledging) (Signature of Notary P A lic-State of Florida) ignature of Notary Public-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Jype of Identification Produced �' IEGIVENS roduced DEANNAMIO _ YCQ�MMISSION#GG022023 (Seal) Commission No. �q •; �(FtES:December16,2020 ommission No. nr Notary Publie Underwrite .,rfof��or BondedTh REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. Jrtxt)G'Ul9