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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLET - OR APPLICATION TO BE ACCEPTED Date: 5 `1 Permit Number: ti1drJ-O Iro� RECEIVED PA 1081017 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: sG, �k Kdc PROP©SED INPROVEMENT LOCATION: Address: Z30 14A-M dock I-d ti C ►?1 3 q9 F l Legal Description: a?- "Mmoc,k Property Tax ID#: 3?d`� " 7�Z- oOO�-- OGO - Lot No. Site Plan Name: Block No. Project Name: - / Setbacks Front b Back: o,ZS Right Side,: Left Side: 13. 2, DETAILED DESCRIPTION OF WORK: CONSTRUCTIO' INFORMATION: Additional work to be perrormed under this permit-c ec a t at app y _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric Plumbing _Sprinklers _Generator _Roof Fe-•-. Yozc.N %q :,.-Fr Total Sq. Ft of Construction:aRCk 3r-cA P9Zb ,if Sq. Ft. of First Floor: - Cost of Construction: $ - Utilities: —Sewer _Septic Building Height: OWNER/LE OREE: CONTRA OR: Name ' ' ' iZo3t­?ZZ) A-ek, 5R 69041 Name: Address: Z3a '` `'IZ���;Z `} ti�nuhoc.k L� Company: ��J Z��'6�� � C4��STz UGnon( City: roe\ State: Address: 1?.0. Zip Code: Sq 9 3- 1 Fax: City: %�� �t �C�-��L State: Phone No. 1-91?-3 73 -q 3 q� Zip Code: 3` 9 el Fax: �9Z- A,0 0 3 zS� E-Mail: Phone No 1 3(O Fill in fee simple Title Holder on next page (if different E-Mail tZkP-YVk/";0 w,b Zq p, Be,ll $o U-�L .A e from the Owner listed above) State or County License CSC 13 Ze7 Z9.3 cc��k If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. 4 DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Sorl Co-!'r5T Ar11unt^!Ory\ Name: 3 Ao T o, Address: i3� e St. N s � to Address:'� l A City: u State:_!F( City: State: Zip: 33')bo Phone 7Z9- 573Z- 9cco Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: nl .� Address: City: City: r°T 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 p�din'ou Notice of Commencement must be recorded and posted.on the jobsite before the first ' sp tntend to obtain financing, consult en r n attorney before commener wor or reur Notice of Commencement. Signature of O ner/L s /Agent Signature o Contractor/Lice se Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 5 k COUNTY OF Sk The forgoing instrument was acknowledged before me The for oing instryT�ent was acknowledged before me this �b day of 0. 20_0 by this c ay of 20_a by \,0 Y"a t d \K cN,"'t .nn (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Public- tate of Florida ) (Signature of Notary Pu I -State of Florida ) Personally Known Personally Known OR Produced Identification ��Pao• DEANNA MARIE GIVENS Type of Identification ;gig••"'°•�: Type of Identification Produced �- =� - MY COMMISSION GG022023 Produced �o��;::;•o� BARBRAA GOOD ES:December 16,2o20 # * MY COMMISSION 9 FF 101 41 o Bonded Th.Notary Public Underwriter,t } XPIRES:March 12,20 8 Commission No. Commission No.�F Q 1 R\ °r�l a EdThNBudgetNotarySery fOFI REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED od-1-7 DATE COMPLETED �J Rev. 712014