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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COM Date: o• , • d FOR APPLICATION TO BE ACCEPTED Permit Number: 0�1Y REE-HIVED Building Permit Application NOV 01 2017 Planning and Development Services PE! 'If!11 1NG Building and Code Regulation Division St. Lucie County, FL 2300 Virginia Avenue, Fort Pierce FL 34982 / Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential ✓ PERMIT APPLICATION FOR: Address: r7il-616-11'j Legal Description: Property Tax ID #: oZ� 0 O©°1. 0 90 • 2, Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: nai wo Mechanical rtormea unaer tnis permit- cnecK au tnat a _ Gas Tank Gas Piping _ Shutters - _ Windows/Doors' Electric _ Plumbing _ Sprinklers _ Generator Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ �d 00 Utilities: —Sewer _Septic Building Height: Name e24 O! < U 1 Address: 66 ( LLJ ; l City: 61 et -ILO e � State: �� Zip Code:,) //•9--')— Fax: Phone No. E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Name: Company: Address: City: State: Zip Code: Fax: Phone No E-Mail State or County License If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. i Ft 6azA"W SIiPFLEMENTAL COiSTRl1C'(ON,LEN I.Atl(N�J�tM1T(0 k DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: I Address: City: I State: City: State: Zip: Phonel I Zip: Phone: FEE SIMPLE TITLE HOLDE' _ Not Applicable BONDING COMPANY: Not Applicable Name: I Name: Address: I Address: City: I City: Zip: Phone: Zip: Phoned I OWNER/ CONTRACTOR A ff lDVIT: 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 appl'cable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structure. Please consult with yor Home Owners Association and review your deed for any restrictions which may apply. In consideration of the granting I f this requested permit, I do hereby agree that I will, in all respects, perform the work in accordance with the approved Iplans, 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 1 ools, fences, walls, signs, screen rooms and accessory uses to another non-residential use WARNING TO OWNER: You failure to Record a Notice of Commencement may result in your paying twice for improvements to your prop, rty. A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. I you intend to obtain financing, consult with lender or an attorney before commencing work or recorc ing your Notice of Commencement. Signature of Owner/ Lessee/Contractor,as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF . �.I;)(�,(f , COUNTY OF The forgoing instt was ack owledge efore me J rume this day of 20 1 by The forgoing instrument was acknowledged before me this day of 20_ by WALL, 0 (Name of per n acknowledging) (Name of person acknowledging) LAAI� �A -1 c�- (Signature of Notary Public- Statl' of Florida) (Signature of Notary Public- State of Florida ) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identifica ' of Identification Produced �l;*a+��;�,, KAREN S. NIELS 115 oiced Commission N FF cy �� My Commission Expi Commission No. �';�,,,��P.�(Seal) June 12, 2018 es CO ission No. (Seal) I REVIEWS FRONT ZONING. SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.