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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO. MUST BE COMPLETED: FOR APPLICATION TO BE ACCEPTED Date: J: Permit Number: • . . Building Per: Application REC-EIVED. Planning and Development Services:. `1 5 1015 Building 6ncl:Code Regulation Division ...... 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X PERMIT APPLICATION FOR: To Select from dropb&, click-arrow:at the end of. line PROPOSED IMPROVEMENT LOCATION: 11298 Muller Road Fort Pierce, FL 34945 Address:.. . Legal Description: 33 35 39 THAT PART OF W 1/2:OF SW 1/4 Or. NE 1/4 LYG S:OF CANAL 71-LESS E 206 FT AND LESS RD R/W- (2.86 AC) (OR 3370-74.5) Property Tax ID'' 2333-133-0001-000-5- Lot No. Site.Plah Name: — :Block No. Perc' /Drawd home addition Project Name: Y Y ..... .. Setbacks: Front :Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: 293 square foot addition to house Additional work to:be erformed under this permit — check all apply: HVAC _Gas Tank Gas Piping Shutters Q Windows/Doors Electric 0 Plumbing :0Sprinklers. Generator Roof. :. .. Total Sq. Ft of Construction: 293 Sq. Ft. of First Floor: 293 . Cost of Construction: $-30,000:... Sewer Septic Building Height::.. Utilities: _ g OWNER/LESSEE: :.: -CONTRACTOR:...:; :...,. Name Rebecca Percy Name: Home owner builder Address:1129.8 Muller Wad Company: Address: City: State: - .:Zip Code:. : Fax: Phone:No. Fort Pierce Fl...:: city -State::_ Zip Code: 34.945 Fax: Phone' Phone No. .:Becca drawd cc.corri ;.:...:: E-Mail: °� Y Fill in fee simple Title Holder on next page (if different from the :Owrier listed::above):. ::: : E-Mail: State;pr County:License.: If value of construction is.$2500 or more, a RECORDED Notice of Commencement is required. ....... r ..... SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable Name: cookandMenard. MORTGAGE COMPANY: x .Not Applicable Name: Address': 806 DelawareAve .. .... :. Address:::: City: Foif Pierce . . State: FI Zip} 34950 Phone: 772-460-7751 City: State:...... Zip: Phone: FEE SIMPLE TITLE HOLDER::. X_ Not.Applicable ::: Name: :....... BONDING COMPANY:::: _Not Applicable :. Name: Address: Address: City: City:. Zip:. ::: Phone:::: ::: Zip: -Phone: I certifythat no work or installation has commenced prior to the issuance of a permit. St Lucie County makes no:representation that is ge.anting'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 aiid'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 of the granting of .this requested•permit, I do hereby':agree that [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 applicatioris are exempt from undergoing a full tdncurrendj'r6view: roorii additions, accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use WARNING TO'OW.NER Your. failure to Record a Notice of Commencement may result in"your.paying twice.fbt improvements to you r:property :A Notice:of Commencement:must be recorded and posted. on the jobsite before the first inspection. If'you intend to obtain financing"itonsult with lender or an attorney before commencine work or.recordine vour Notice of Commencement. - ....... ....... ..... ....... ...... S _ Signature of Owner/ Les/eeV gent Signature of Contractor/L'cen e:Holder STATE OF FLORIDA- STATE -OF FLORIDA CO.UNTY:OF::. L CACOUNTY OF. ...... l� The forgoing instr ent was acknowledged before me The forgoing ihstru ent was acknowledged before me �i' day of 20 by this ay of 20 Toby thi y ". .. :: I ` a �1 ". ...... (Name of person acknowledging ), .. (Name of person acknowledging ) A n Si a re of Nota ( g ublic- State o f Flo lda (Si ure of No Public -State of FI ri6a ) 17 Personally Known •Personally Know �'►h' ' Type of Identificat n,^ JENNIFER MEDECKE r' Type of Identifica o. Pr uc� -Commission-No. �= Notary Public - State of Flottfd� My Comm( j1es Oct 4. 2015 ` Commission No: :. Notary y Public - Stale Of ppriip MY Ili) Expires. Oct 4, 201ti ::.:.:: '.,,o� �..•c Comelltision # EE 13SA43 ::. :: .. , :.:. <.,°f .� ....: COM111lon :EE 13SE/S . Revised 07/ 15/2014 uuivirLCIC - Ps v, v - INITIALS