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HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 _ Date: Permit Number: Building Permit Application : (-"%E f11VE® Planning and Development Services Building and Code Regulation Division NOV 1 117 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial ResidentW St. Luele County, rzl PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line RROPOSED hMPROVWE'NT LOCATnLC►N Address: l 1,C� r i' U)n IF, Legal Description: �� `uc �� Gar {hs 0 5 3 CQ L(S I(, S �-ry Al lfT 5 o C- Iso (7 LPSs f 330 PV Property Tax ID #: �I �(' ( l (yo 3 50 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED.DESCRIPTION OF'VIJORK . ., CONSTRUCTION„INFOR_ ATIO'--N ,,.,. Aardrtio workto e e me under t is pe it - check a apply: 0/'e HV C G Tank as,Piping Shutters endows/Doors _ Elctric I� Plumbing Sprinklers Generator _Roof Roof pitch Total Sq. Ft of Construction: Lf/s7 S In of First Floor: p-b Cost of Construction: $ �d �r �� © Utilities: Sewer _ eptic Building Height: OWIUERJLESSEE CONTRACTOR Name ,z-, c1 S�i P c4 o o`er' Name: I Company:(3V-0L-t2 C09 CzylI "{'ualoh 0e✓` i11 Address: 3) 5L., (deal- CKv— C U City: Pe- ( • Lvc,--Q- f�_ State: FL Address: In30)- S • EgkifcO HWu#1 U. Zip Code: 3 t(V' (- Fax: City: R�L &. LG 2 PL_ State:�k Phone No. � -7 D' --) 3 7 ' 5 °"o Zip Code: --?,49 S2 Phone No. -7-7Z - Fax: - 112 - 2-'10I E-Mail: Yl : cofQ 6e Jdov-0- 0— Coc•. Fill in fee simple Title Holder on next page (if different E-Mail: YYl I ��e i-Y, I I'G I'idG �� y Q01 • C6 from the Owner listed above) State or County License: �'1 �25 U U KW I If value of construction is $2500 or more, a RECORDED Notice of Commencement is requires. 1i"� 07)_10 -_�blo-1L1 dC ;SUPPLEMENTAL CONSTRUCTION. CIEN .LAW INFORMATION: 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: 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 attorney1wfore rnrvimen rinn %kin A, nr rnrnrAina vni it IUntira of rnmmPnrPmPnt oz__ J, Signatur ontractor License Holder . Signature o wner/ Lessee/Contractor as Agent for Owner STATE OF FLORIDA U )d P' STATE OF FLORIDA COUNTY OF :Wt ( QC1� COUNTY OF 1Y7)t The fgoing instrument was acknowle ged before me The for oing instrument was acl no I dged before me day �� by v�iY)�,, this d� day of (\ �%�. GIPj�20 by this of ,j20 1�> I"l Y-0 j d0, Name of pen making statement Name of person making statement Personally Known \4 OR Produced Identification Personally Known X OR Produced Identification Type of Identification Type of Identification Produced n Pr iced (Signature of Notary ublic- (Signature s lei aUl;Pso8 (Signature of Nota Public- St e oFlorida Mc IZOZ'ZO>id �IdX3 �_ Commission N v�'►o :° �° p,COISSION #GG089104 Commission No. -G tWI ES APR02,2021 09J# Npd}l"SSIW OO JAW °'��d Are �: a Bonded through 1st State Insuranc ;QN'3113 31001N REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17