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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPS D FOR APPLICATION TO BE ACCEPTED Date: - - Permit Number: G rI j I D-T I ' ® ECirag E _ n ...., �.. Building Permit Application Planning and Development Services NOV 1 6) 2017 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: FV4 j) ON , PRQPOSED INPROtTEMEIUT LOCATIQN Address: LtCAka Legal Description: iU_DiAO RIVE(L2s;LYA 7`rS - U TJ X 0:1 - A-X aV J-dT- I Q Property Tax ID#: (00 - 00g9 - DOO A I Lot No., � U Site Plan Name: Block No. aS Project Name: Setbacks Front Back: Right Side: Left Side: f � DETAILED DESCRIPTION'QF WORK: 3 j eem nld 0 � ca 0-2-S ® h e- 4h (M-e- w i l l \e- r IIYYI tl I ,s LJ I d c 11 Q icr) GONSTRUCTiCrN {NFORIVfATIDN Additional work to be per orme " under this permit-check all that app y: I _Mechanical Gas Tank _Gas Piping _Shutters ?L Windows/Doors _Electric _Plumbing _Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: i Cost of Construction: $ a-©0 _ Utilities: —Sewer Septic Building Height: 'OWNER/LESSEE: %CONTRACTOR: Name �E.S�<'0 /_N-U:J J, -,(1�� i�r1�� _ Name: I, vi Address: �c1 SC'.14( 2rr1n�. �2t�/2- Company: ' JI e izo\ ,ZA F-uS S City: �c-(2i PIuz_c�2_ State:' r- = Address: Zip Code: '6`{'q K Fax: — City:Vic:eT 12 iL'T_- State:1J Phone No. -7 7,a - `-i CA; Zip Code: 34� 'RD- Fax: -- E-Mail: Phone No 7a - 3S 3-C,14-c, Fill in fee simple Title Holder on next page( if different E-Mail (r, TS e- G.nna, ` . ('UY� from the Owner listed above) State or County Licenses . 0 If value of construction is 2500 or more,a RECORDED Notice of Commencement is rlequired. Romp St1PPlEIVIENTAI.CO;NSTRIXTIQN LIEN LAUV INFD.RiVIATIQ[V. DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone `7 ±oR -- 5S 1-7 S- Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: 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 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. Signature of Owner/Lessee/Contractor as Agent r Ownerl: S4Kature of Con ractor/License Hol r STATE OF FLORID -N STATE OF FLORI COUNTY OF `� COUNTY OF N I !` T ma W_R, I g g g `ems ° ! The for oing instrument was acknowledged e r�ti�e The foI oin instrument w s acknowled ed beforfe fn�„ i g Ci: U n this day of / 20 by �_ this day of N dy 20 1 .b� z �_ G UX ,LL o c :J se uJ�l47 I u UK �r� (Name of person acknowledging) . - &y (Name of person acknowledging) m ko•M•bOc` (Signature of N ry Public-State of Flor a U (Signature of o ary Public-State of Flor a ) ;L :. .: Personally wn OR Produced Identification/ Personally Known OR Produced Identification Type of I ntific ion . Type of Iden�ficati n ' Produced wl c—, Produced Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.