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HomeMy WebLinkAboutBuilding Permit Application40 ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (� j Date: Permit Number: Building Permit Application NOV 0 7 2017 Planning and Development Services Building and Code Regulation Division PERMITTING 2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie County, FL Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential ,/ PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: O. ' ` l J C Legal Description: 30Sb N (A.) 1cO�Q C'�I I �P V�1 C�� c.1 � ( `i V P y b -n Property Tax ID #: q9 ` 's © C)b\ Site Plan Name: IEeK- Project Name: r0-21 Setbacks Front Back: Right Side: Left Side: Lot No Block No. CONSTRUCTION INFORMATION: Adclitional work to e e orme under this permit —,heck [] Gas Tank ❑Gas Piping a apply: Shutters a Windows/Doors rHC Electric ElPlumbing Sprinklers Generator Roof Roof pitch Total Sq. Ft of Construction: S Ft. of First Floor: Cost of Construction: $ 1_7, �Q, ®O Utilities:] Sewer Septic Building Height: OWN ER/LESSEE: CONTRACTOR: Name 0 h Name: Q Q ,�IIS Address: OSb U►F Company: �c ^l City: State/_ Address: 700 SE FeiJPL,,A1 O Zip Code: 5YCI O Fax: City: S—I.,C`V — State: Phone No. Zip Code: '54:191 Fax:-772 2-23 q72 E-Mail: Phone No. SCP ( Jet (a S 1 2--T Fill in fee simple Title Holder on next page ( if different E-Mail: t ` S e—cl-C_k o6_0 I o cow", from the Owner listed above) State or County License: i<G CDCO it value of construction is $Z500 or more, a RECORDED Notice of Commencement is required. N N SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: State: Zip: Phone: City: State: Zip: Phone FEE SIMPLE TITLEHOLDER: _ Not Applicable Name: BONDING COMPANY: Not Applicable Name: Address: City: Address: 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 vour Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent for Owner I Signature of Contras/License Holder STATE OF FLORIDA M STATE OF FLORICOUNTYOF a t�4-(n COUNTY OF The fo.Moing instrumA- ep�t was acknowledged before me this � day of IV 17 V . 20_D by Ada m, 9nA nto Name of person making statement Personally Known >< OR Produced Identification Type of Identification Produced (Signature (if Notary Pub[' Commission No.GC k r �i REVIEWS FRONT COUNTER DATE RECEIVED DATE COMPLETED Rev. 8/2/17 The for ing instrument was acknowledged before me 'this rday of A to ✓ 20] J by Act � SCA CLO Name of person making statement Personally Known )�,— OR Produced Identification Type of Identification ature (W Notary Public- State of Notary Public State of Florida t C n Public. h� My Commission GG 131021 «� • r� Notary Public Sl mmission No. C/ ;P Cherylynn Pai d�a Expires O8/Oy2021 Q 'Dtq,�,d� My Commission Expires 08/02/21 �► ZONING SUPERVISOR PLANS VEGETATION I SEA TURTLE MANGROVE REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW 021