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HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLC i ry FOR APPLICATION TO BE ACCEPTED Date: � �� Permit Number: ,Joe, r_ �: FRI,��.- 17 Building Permit Application JUL .1 3 2E 36 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 PERMIT APPLICATION FOR: kh_W �O60 / Address k J (Q� Legal Description: I_jAj t-r Property Tax ID #: Site Plan Name: < Project Name: Setbacks Front , '% Back: C nWrW.�M= v,M II IAR© Right Sider h_)j, 8 Left Side: PERMIiT i'r St. Lucie ioLsnt\!,,F L c Residential ? . d Additional work to be pertormed under tnis permit - cnecK aii tnat apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors 4�zlectric \,60umbing _ Sprinklers _ Generator _ Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: Y f �� �' Utilities: —Sewer —Septic Building Height: N am e,0 r CAL C I-> Addres . r City:1P Stater Zip Code.. ax: Phone No.Jo E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name: AV'45X"— =/ U LDrL.1rYti Company:- "L)OQ Address. City:h-T fi l if 1—G (f- State: Zip Code:,y3y !?.2 a Fax: 146 :5 "/ U (c 3 Phone No E-Mail D d State or County License if value of construction is 2500 or more, a RECORDEDJ�lotice of required. , DESIGNER/ENGINEER: Name: Address: Not Applicable City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: Phone: MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone• BONDING COMPANY: Not Applicable Name:_ Address: City:_ 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 Commencer T ent 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 rnmmencing work or recordine vour Notice of Commencement. Signature of Owner/ Agent/ Lessee/Contractor Signature of Contractor/License Holifer STATE OF FLORIDA STATE OF FLORIDA i COUNTY OF i / � D COUNTY OF La The orgoing inst ment was acknowledged before me The forgoing instru ent was acknowledged before me this r day of 20_1-7by thisol day oft, 20Pby 'k nz, r -e 4 L' p 15 11 1-ZZ-7- 6 6 � IA/ (Name of per Pn ackno7 ing) T(Nam-Ifperson acknowl, ing ) -`(SignalWe of Notary Pub orida) ature of Notary P ate of Florida ) Personally Known OR Produced Identification Personally Known I OR Produced Identification Type of Identification Type of Identificati Produced SiiERRIFEHLUAN Produced SIHERRiFEFiLivAN Commission * �' * MYCOMI,?ISSION#FF1003i0 `"° e�YPIRES:AvIa(ch14,2016 Commission No. era MY COMMISSION# FF 10037 '� Se PIRES:��iurrh14,20i£ -No. "tea,. �OFF��� Sort edThruNdgetldotar/Services ti°� BandsdThruBuuge!iac r/Szrvic• �OFF'D REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. ,