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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:. S"Ify Permit Number: Building Permit Application AUG 14 201? Planning and Development Services PERPAITTi NG Building and Code Regulation Division St. Lucie Count.•, EL 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 4624578 Commercial Residential PERMIT APPLICATION FOR: PROPOSED, IMPROVEMENT LOCATION:: Address: _ I`�� I�3.� cc (zm'•.c-,. Legal Description: __ iZ,V �` \�Cv- ^ �i in i •�- �� cc'� Ll �i �L9� << PropertyTax ID #: 3L411 •--5-3 Q' ®000 P 7 Lot No. Site Plan Name: Block No. Project Name: r\cL Setbacks Front Back: Right Side:. Left Side - 'DETAILED DESCRIPTION OF WORK r CONSl'RUCTION INFORMATION _ Additional work to be pe ormee under tis permit - check all that apply: _ HVAC _ Gas Tank _ Gas Piping _ Shutters Windows/Doors _-Electric _ Plumbing _ Sprinklers _ Generator _ Roof Roof pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ 2-2,00 Utilities: —Sewer Septic Building Height: :OWNER/LESSEE: �CFJNTRACTOR. Name 2c,r t QCAS Name: Company: O tow Address: At rest, 9cLp o_, Aj City: - PorT sc L-aJ4_ State: Fl,• Address: _Tll1 --,,J t.060e_ 9d City: P, S, State: PL, Zip Code: 3`��i�-3 Fax: Phone No. i?T- 3S" S'- I3S-0 Zip Code:' '14W3 Fax: :3a-3-=07655 E-Mail: Phone No. "77'.)--- 94 -07951 Fill in fee simple Title Holder on next page ( if different., E-Mail: t13 i.; koy, State or County License: �f•�[�_!r}�(QD%S� from the Owner listed above) If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. dw e- y 0-vtckw, Cow DESIGNER/ENGINEER: _ Not Applicable Name: ML\y,� m. �s Address: eW o- City: r+ i� i e .n� State: l�C Zip: :349f- Phone 77�,^ Z-?o - ?V.47�I FEE SIMPLE TITLE HOLDER: Not Applicable Name: Address: City: Zip: Phone: ;ORMATION MORTGAGE COMPANY: Y NotLApplicable Name: Address: City: State: Zip:. Phone: BONDING COMPANY:Not Applicable Name: Address: City: Zip: Phone: - I I •I 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 your Notice of Commencement. Signature of Owner/ Les /Contractor as Agent for Owner STATE OF FLORIDA COUNTY OFF. �1�1 The forgoing instru ent was acknowledged before me this day of Q,20. by U`J �Lk�lz Name of'person making statement / Personally Known OR Produced Identification •/ Type of Ident' ' tion Produced VL ©U rT Signature of Contr or/License Holder A STATE OF FLOR COUNTY OF � • The for oing instruftntas acknowledged before me this day of 20by . . Name of person making statement Personally Known OR Produced Identification d Type of Identifiesion cry. (Signature of Notary Public-5 ate Florida )��7on (Signature of Notary Public -State of Florida ) Commission No. a `"....""' S V�i?EN S. NIELS I 31CO mission No. ,,J.> °°;� e 1 S K' REIELSE `°"'� °�'=(SaY - �� miF 1-156 My Con Expir _ o emission k FF 11 6 s =*. ° Commission Expri MY ;; ;`Jun201 8 `o%'Eotr.o;,�' June 12, 201 8 REVIEWS FRONT ZONING, SUPERVISOR PLANS . VEGETATION SEA TURTLE 'MANGROVE' COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED {l DATE COMPLETED ✓ Ct Rev. 8/2/17