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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICiiCl°�E INFO MUST BE COMP'+t FOR APPLI ON TO BE ACCEPT '�� 4 d Date: Permit Numbe : \ a SG .: L IF RECEIVE® 619 Building Permit Application OCT 112018 Planning and Development Se ices ST. Lucie County, Permitting 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,ROPOSED'IMPROVEMENT LOCATION rv. YS\. �. Address: - --- _ =---� /C D ✓/ Legal Description: Indian R %Ve.r o+ 32 �,A3L4l I N OR 3gq(D-(0qq Property Tax ID #: -7-'*)Li 2- - Coo9 - 02 10 000 "-7 Lot No. 32- Site Plan Name: �61 r" P k\(e-r � "C_'-�C'r :<! S Block No. 5 -1 Project Name: C�-(a- Rclaam Setbacks Front 3 (D , Back: Z I . � Right Side: Left Side: Si nq le, fam I (y re-s,i d can c e, 3/2- / 2 [DHVAC EI-Electric D Plumbing Total So. Ft of Construction: 3 I '15 Cost of Construction: Gas Piping Shutters Windows/Doors Sprinklers FIGenerator E!Roof Roof pitch S . Ft. of First Floor: Jc / 22g 5 A/C Utilities: 1J Sewer ©Septic Building Height: I'CIWN'ER/LESSEE _ , "CONTRACTOR NameJ'Q - . 4Li? Jr-4- K_.r -1-IP. WU Address: Jc 00$ h Mi City: r State: i_ Zip Code: Fax: o Phone No. q - _ O E-Mail: I A rYIP(�'\C'YI I C P g q@ n rM i, � 11M Fill in fee simple Title Holder on next pale ( if different from the Owner listed above) Name: Nrld rem (2 ' ClJ I r) Company: _Pac?, 2-om - � 1"1C Address: �. I2 ?�3' _SEPnr+ S+ UL6e_ P�Ivd- City: P( rf-&- 1' �t Stater Zip Code:_-�4q FS a Fax:-I1a -3L40 --(_9)3 Phone No. —I a - _5L40 - -7aa3 E-Mail: (),(` MI n e IMCL 2000 homes. C Om State or County License: RC Q�5 q 35�9 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. 10/11/2018 15:28 7773407!�, PACE PAGE 02/02 • •...12 e.riW MRI - 5(�L Phone FEE SiMPLE TITLEHOLDER: ., Not Applicable MORTG GE COMPANY: Not Applicable Name: Addr k 1. 1 Ew City: Y State: �L - Zip: 3yC`LD Phone: 2 �� BONDING COMPANY: Not Applicable Dame• Name: Address: Address: City: City: Zip: Phone; Z(p: . 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. I.ucle 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 coyenants'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 lendap-orwl'I`atto er�y before commencing wor Notice of Commencement. Signature of Owner/ Less a ontractor as STATE OF FLORIDA COUNTYOF - S+ The forgoing instru ent a acknowledged before me this. day of 20_b by _Aida) r4a"l n Name of perkap making statement Personally Known OR Produced Identification Type of Identification Produced L-k S. (signature of Notary Pilibil to of Florida ) Pena S,11mier Commission No. 'if �y( MON elnber 15, � r$o Ilw Ann Nall y REVIEWS I FRONT I ZONING COUNTER REVIEW Rev. 8/2/17 Signature of Contractor/License Holder STATE OF FLORIDA. (J COUNTY OF 0.3T The forgoing instrut a acknowledgIdpefbire me thitv)dMJ day of V 20 by /'t Name of pe oA making statement Personally Known x OR Produced Identification Type of identification Produced LOA S AktLa) (Signature of Notary Pub e• State of Florida) (>8U19 S. Bleler Commission No. &G o' Cornmii�5lta Qt163a8A3 *• '� EiON Se lber 15, �QZ6 BMW. thtli Aerrtmm IllolW SUPERVISOR j PLANS I VEGETATION SEATURTLE I MANGROVE REVIEW I REVIEW REVIEW REVIEW j REVIEW