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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLE ED FOR APPLICATION TO BE ACCEPTED Date: 7 '02 7— 02 Permit Number: 7 Q CCIR > - „z REWE i 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: `kO02 dV—, t�' Ji PR+OP©SE� 1NPR,OVEMENT L®CATION: Address: g 3 P `7U'tt&�-) Gdifd, �c�NS1 n/ d eil. F Legal Description: Property Tax ID#: �S�Ua " 5 / //. 0'1 V-CO Om Lot No. 9 YV Site Plan Name: N //4 Block No. Project Name: N1 Setbacks Front ff /t Back: A/ f1 Right Side: Left Side: /✓ �f AL � � I �' Of ' O • a.v44 Z' v C®NS UCT O FORMATION: Y=ffionai work to ne per orme un er t is permit—c ec a t at app y: _Mechanical _Gas Tank _Gas Piping Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator • Roof �/ itch Total Sq. Ft of Construction: p� �� Sq. Ft.of First Floor: �,4 Cost of Construction:$ ®Q Utilities: 4j96ewer A$/ Septic A//iiuilding Height: OWNER E"SAS E. COON RA • R: Name ..,f Name: Address: 9 ,, -. Company:Qgc '=a'�� -:' City: `State:_ Address: //V"V-1 b 7c% Zip C de:3 y q .S'7 Fax: City: A 1 SO Lc: N c.L. State: !- Phone No., /— !odor 76 a�Z Zip Code: S3 4 SSJ Fax: '7 U E-Mail: 02 1J-0C-- CO ik� Phone No 77 4- 90 Fill in fee simple Title Holder on next page (if different E-Mail / D OI h e ue,N /V O I)Aot- YI /1 OM from the Owner listed above) State or County License C C• l,'a 7 �o ,7�/ if value of construction is 2500 or more,a RECORDED Notice of Commencement is required. U'PPLEMENTAL C«ONSTRU'CTI©'N LIEN LAW INFORMATI® DESIGNER ENGINEER: _ Not Applicable MORTGAGE COMPANY: . Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: s 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 comme'n1 ci work or recording our Notice of Commencement. Oat, c?c ' Sig at re of Owner/L see/Contrac r as Agent for Owner Signature of Contractor/License Holder fl STATE OF FLORIDA STATE OF FLORIDA COUNTY OF C4 . W C_ �-P COUNTY OF 5+ . L U C t-e The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this QL-1_day of GP_Q] e_Cr \2f ?_(' ,20_1 by this-0 1 day of —"-')P 04e M h-er, 20-10 by ,,M � J - 6 4-P(69 _ S (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida ) Personally Know ation Personally K A Qe I&^����a� �dPgr�f' ion Type of Identlf�oaxjon Type of Identif,_tl .Fa oue��,,,, CARLA NELSON o` m,•, CARLA NELSON Produce Florida Produced :2• °'= ryppe g;a Florida ` ' ' Commission#FF 965535 Commission#FF 965535 - ar' Commis ' ( mm Expires Feb 98ev?o Commissi lk ,,�d�� My Comm Ypires Feb�� o nnu� REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 7/2014