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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE �_%.V'APLE i cu FOR APPLICATION TO BE ACCE D Date: Permit Number: I DEC 1 5 2011 W ." �' i Building Permit Application Planning and Development Services . ` Building and Code Regulation Division 2300 Wiginia Avenue, Fort,Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential_ F PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line S Address: _ '- -3n1� Cu 0We55 P tcct VC, C T l Legal Description: • I6 Si 40 S Ya oV' 0 F_ V# 4 1/g 3o Io tG Ac.) Coc- gogs-- I q 3 S�) Property Tax ID #: 1 L( 00 % - a®O - S Lot No. Site Plan Name: Project Name: D 'I IC_ jaerg 3Ce►.Ct Setbacks Front (oo ` Back: (&q, qca l Right Side: fo5.3 o LeftSide: 146 Swu�le. �� ly MIcA.Znce- 3 Block No. COIVSTRU"CTION `�NFQRMATI©N Additional work to e nertormed un ert ispermit-checka apply: OHVACY Gas Tank FIGas Piping _ Shutters F;-'] Windows/Doors Electric © Plumbing Sprinklers 1:1 Generator ©Roof Total Sq. Ft of Construction: 4 , 0 3-7 S Ft. of First Floor: Cost of Construction: $ '33q Soo Utilities:n Sewer.lJ Septic `/ ,o 3'1 Building -Heigh#:" f OW ' ERAESSE'f: Y' 4 CONTRACTOR: ' £ . Name K,ycy�. ,... �o�.�C'. ...... Name:- --_._.- -•_(y4�1Ai Address: '' a9`tS�c).Wlira�.. ! Siv--eci iCompany: ` Co�ti:'nie,_af� "4 i�r►: � Tv � State: iAddress:, I i!-1 �. 7�=1�� lCity:- ' `i-:`- Ptizr" - - State:L.. Zip -Code::: Fax::-_:' Ca73,) &ir``! -aa)a Phone No. (-7 73A) at(, - SIfy Zip Code: 3y01 ►J Z Fax: Phone No. -i%Z- &I E-Mail: Q-')CPr,& 1)0�& . earn Fill in fee simple Title Holder on next page ( if different E-Mail: 1)" ltQP,LJQ14 le nn61e=.0%Q `1 . LC' AA State or County License: CX(, i 15-.04 T�30 from the Owner listed above) co',Ak &'+ : 36 as Z_ If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. N DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: krc hrie aniG iAc: i I Name: Wot r Cor>`mAnJ4 l�au►� Address: UOG Lai Address: y®o0i p�eC�„k,{r��_ JIL)- A City: rro,r it Q a -_•rr a State: T- — City: 7:gA State: Vvr t- Zip: -�ti450 Phone: -771 • NCo-7T5 Zip: IL(gLA7 Phone: 7-17, a3tq FEE SIMPLE TITLE HOLDER: X! Not Applicable Name: Address: City: Zip: Phone: I BONDING COMPANY: Not Applicable Name: _ Address: City:_ Zip: Phone: 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,lthe 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.1A 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/ Agent/ Lessee Signa ure of Contract /Lic o er STATE OF FLORIDA STATE OF FLORIDA COUNTY OF ,S&, Ls a e _ i COUNTY OF_&a 1Aid e The forgoing instr ment was acknowledge before me The f1orgoing instrument was acknowledged before me this a day of 20� 1_ by this A lday of UIPCO.Ca W 2011 by v and 1,0 CAJW 6 (Name of person acknowl dging) (Name of person acknowledging) (S' ure of o a. ublic-State of Florida) (Si ure of Notary Publi tate of Florida ) i Pei•sonally-known OR P oduced Ident'fi�ation ✓ ersonally Known OR roduced Identification Type of Identification Produced i IV'P/l� .C�n�P Type of Identification Produced�a�/iP/1 C2f1 S� r E LAPRADE ' Commission fJo.?C't' =aNl,, Commission No. Af�41�tM) LAPRADE MY OMMISSION # FF224737 a MY COMMISSION A FF224737 %os j EXPIRES April 27. 2019 %1% • EXPIRES April 27. 2019 Fbnaallotn-vsmwce crar ..C/:pl;,.u•�:: Floridallots V5ei mcon• Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS