HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4 Permit Number:pop
Building Permit Application RECEIVED
Planning and Development Services APR 2 0 2017
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
:Phone:1772)462-1553 fax:i(772)462-1578 }Com r enciaa Residential X
PERMIT APPLICATION FOR:
PRQPO�EDIIUPROVEME) }�
Address: 04 14 ak?Gtd Eoaek 5 C Lt CgngQ L 3 l`
Legal-Descri tion: ?j(( Z g ?() 1 t -h3tt am (G5S R. C[. 4 d " W
OF /V li !, L L/67 W D'r $sc-r 6 rzv� r7 a a le,55 C-7-4 o oy l Pte r wu � - 2
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Property Tax ID#: -f- t I :Q O D Z - UDD -2 Lot No.
Site Plan Name:_(:/,/1 n� jZ"cJ-) Block No.
Project Name: 5raj�21 e
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Setbacks Front Back: Right Side: Left Side:
s ✓ ro .T� ��,i`s sa ay I °[4 x t- fE,.,4 a: als4aF Q.i a eye:
DETAILED DES )PTION`O t WORD
rebu4 '1 d 6ktblc--� �C .
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i�#STR�CTI'�Ii�I'CkRt��► C�� � s � y a f ��.; ' � �s��, � W ��� . fS h � {
Additional work to be nertormed under t is permit-check all thatapply:
LLIHVAC Gas Tank Gas Piping Shutters UWindows/Doors
®Electric Plumbing Sprinklers 0 Generator Roof Roof pitch
Total Sq. Ft of Construction: ..�`'' t/v �� . Ft.of First Floor:
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�CostofCons�truction:$ �� 'Utilities:' Sewe-r�Septii Building i#eight: � b
OWIRJtss � � cOrl�Ac�tO
Name U Name: tql
Address: ��� C(C CC GY • Company: �� >� �fUYt I�GS
City: State:_ Address: 2-000 GOW af7 Ca-
Zip Code: fax: City:dDCa �t� _ State:
Phone No. Zip Code: ?4-3Z Fax: u «O
E-Mail: Phone No. (3&I ' Z I •
Fill in fee simple Title Holder on next page( if different E-Mail: a1Vb'f_C b)r7C61
from the Owner listed above) State or County License: GG-1 C 64 Q-14?0
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
ENT '4O1��� y ����fr!'s
.4,
0ESleMER1EM61MIffRn -NetApplieable MOG�TGA@E'COI PARY., x . Ktot Appffca"ble.
Name: Finnvold'Architectura Game:
Address: 8000 N Federal Hwy Suite 116 Address:
City: Boca Rabon State: FL City: State:
Zip. 33487 Phone: 661-3064286 Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not Applicable
Narrle: -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 iFt coriffict with any applicabl'.e Home.Own,ers.Assocration rules,bylaws or.and covenants"Ahat may restrict.or prohibrt such
structure.Please consult with your Home Owners Association and review-your deecrfor any restrictions which mayapply.
In consideration-of the"granting of this requested permit, [-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
bei re the ffirst:►nspectiQn. if ysxu1ntendAclobtaire- in,ancing,iconsuit with;-Iende•r ara:n attar<ney before
commencing work r recording our Notice of Commencement.
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Signature of Owner/Le ee/Contractor as Agent for Owner Sign Contract i rise Holder
STATE OF FLORID STATE OF FLO A
COUNTY OF F a COUNTY OF IIZZ4`e
The f r ing instru ent was acknowiedge �efore me The f r oing instrument was acknowledged.before me
V � / Y (7
this day of ZO _by this, day of �( ,20 by
V06mig 6N ,5 JUhm Tl��
(Name of person acknowledging) (Name of person acknowledging)
&-,6 24itv�z 4��0410t&v
(Sigriature of:No.tM kPublic-State of<Elorida) (Si nature of.No'tary Public-State of Florida)
Personally Known N OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. o v1Jj LL +° Commission No.KIM A NO is
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,
IIC State of Florida s,., KIM A NOTORIS
. ?My Commission Expires My�88'41'4
2017 Notary Public-State of Florida
:Revised 07/15/2t314,;" �`� Commission# ,.;» _ :fir; My Commission Expires May 9,2017
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` � of oQ;' Commission#EE 884154
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