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HomeMy WebLinkAboutBuilding Permit Application I ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: S Permit Number: RECEI� D APR p 5 2017 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 Vz PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PR ®S D IMPR®VEMENT LOCATI ;N: Address: 5LI1 4ox -YY,an rp—a , F4 91c-CGQ_.-r- _ 3LI94-1 Legal Description:-1 35 140 f2om SE CoP_ 6F S)'-!fy n�Y A.,v tj ryf33.9E:j; -n4 wzs r1 FbC6000,Tr* Zzo �, d z9 t=; 5 r'95.85F1. TN E Z �-'r 7a Po o 4ri o7c)1 j.-61j Ae-)(�o(R 5'35-Z(o 2.0) Property Tax ID#: z4uq- ®Oo(- Ob0-6 Lot No. Site Plan Name: Block No. Project Name: Mcxjr('a Setbacks Front Back: Right Side: Left Side: CONSTRl1 (®N I.NF©RMA ION: clitional work to be nertormed under t ispermit-check all apply: ❑HVAC Gas Tank Gas Piping _Shutters ❑Windows/Doors Electric Plumbing Sprinklers Generator Roof Total Sq. Ft of Construction: S . Ft.of First Floor: oa Cost of Construction:$ �� 55�. Utilities. _Sewer Septic Building Height: O�WeN E R� E-�S CONTRACTOR: Name mr_,c gip_ GocLJcz_\vow M�z nnn2 Li�,nCL Name: Robert Zrallack Address: 5ql \-kax+Mck n ea Company: Solar Energy Systems City: State: �:L_ Address: .160 Smallwood Avenue Zip Code: 3 i-Iq�"1 Fax: City: Fort Pierce State- FI Phone No. -1�.�-��01- t7�(o� Zip Code: 34982 Fax: 772-466-7937 E-Mail: Phone No. 772-464-2663 Fill in fee simple Title Holder on next page(if different E-Mail: vpsolarenergy@yahoo.com from the Owner listed above) State or County License: CVC056637/9057 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUP•PLNTAL CONST'Rl.l'CTfO�N LIEN LAW IN�®R�MATI©Nk: �� ' ` DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable Name: 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 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 commencing work or recording our Notice of Commencement. 2J�LJL/,___ — - ( I'll— s _Signature of Own_ ssee/Agent Signature of Contra r cense H der STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 54— CL,,c1e_ COUNTY OF `rL Lxtcz,,_ The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this_�Jt41day of_a ri 20 0-by this 444_�bay of ranC i 120 1-I by Robert Zrallck 1 Robert Zrallack (Name of person acknowledging) (Name of person acknowledging) 24 L(4 GG 22A,_ (Signature of Notary Public-State of Florida) (Signature of Notary Pub ic-State of Florida) Personally Known / OR Produced Identification Personally Known OR Produced Identification Type of Identification ProducedSarah A4 oType of Identification Produced sic NOTARY PUBLI NOTARY PUBLIC Commission No.FM(2137 ) STATE OF FLO IDAOmmission No.�'_c/I21 37 � I �STATE OF FLORICIR Comm#FF91213 1� Comm#FF912137 Expl Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS