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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION� s ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: ti i. yy "thn�ad t�- Building Permit Application li ® n Planning and Development Services DEC 19 2017 Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 / Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential �J PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Re n 0-V 0,+ i -&-n Address: 78 J"�r zaeliF FL 3`/1 Legal Description: ls;- 1?119L L " e6 -- _re_ - 110/o 7-/. 8Z45 e ® /Z 2_7� -zlO7 Property Tax ID #: 33ZI - St_Z - OdLS-8 -00 D - 7 Lot No.0 Site Plan Name: 78,97- J;4 c; e/Zo Q X -b _ Block No. Project Name: 7912 r19.;)2'ee-XApoK P X , Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: iZFh'1 a VC C- icy A/l 7"i Lc's` 4 A/ Dv/Zo C OCR C%"64' � f tee✓ �"C Ie6E J14 GL d.✓ Z ��>vwcz�'. �..�s,��� .rr6/✓ �,>✓C-.t �,�,✓. /e%r �c_ a�E,✓� i��>a�� 10o6'w 716c 14/,S7-4CL z NE/✓ ✓/-1n/Irl-F.S axl"'✓e,_ ��C/J%'�n�� /✓A�/L f', ,3L*VC--; _ LI've,_r. /ZcN i= • (r!/Rc L✓!!L i N' lr /.✓ d/a %%1S A,✓i7 /� iTellF.c/ U.5 /,✓(- L7C S; i n/G a i.e. ec/ /TJ. j^JSfAjc T/LE Big c',CSPC/JJ /' /i✓ iC/Te/7E.✓. R/1-rey i' 7c)XY'/1Ae- D1 4,A14 _ ?73 H/19@L/. CONSTRUCTION INFORMATION: Additional work to e e orme under this permit - check a tat app y: F1HVAC r] Gas Tank Gas Piping Shutters Q Windows/Doors © Electric ® Plumbing Sprinklers 1:1 Generator F]Roof Roof pitch Total Sq. Ft of Construction: Cost of Construction: $ /«- DD S Ft. of First Floor: _ Utilities.. Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name 111WA YVAI .f/-/A/BEEF Address: 79%Z J-ADD Ce Zeo0,e _.z . City: 1001[r S� Lc/ e/C State: FL Zip Code: J4/,1 86 Fax: Phone No. 772_ - '7 ®? - 6 8 S1? Name: F/X D t_r e70/✓ 60 Company: 1.L 6 Address: /SCE Z J'/✓ J,14, e/<<A.I4 e/C 4 V,::' City: PO17-T J'T State: rL Zip Code: 3�1 G°i S.? Fax: . Phone No. 02Z-) 1Z&Z(a4' E-Mail: /yIONJD©L.. Gal/ Fill in fee simple Title Holder on next page ( if different from the Owner listed - above) E-Mail: efL7_V/Ve2_7 @C/�%/zEHa.yCJ: e0141 State or County License: 67- /3Z 47& 9 / If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: K Not Applicable Name: Address: City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: ✓ Not Applicable Name: Address: City: Zip: Phone: MORTGAGE COMPANY: K Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: _Not Applicable Name: Address: City: 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 your Notice of Commencement. -- Signature of wn Lessee/Contractor as Agent f Sig t of C aor/License Holder ' :�,";;� •`"' ct STATE OF FLORID g STATE OF FLORIDA -moo COUNTY OF a MCIm COUNTY OF a rn_ pox The foLgoing instrument was acknowledged beforThe for oing instr ent was acknowledged b this day of 20 f'l by g this_Ly day of e 20_a zo J"Z/�c/ N rn %�y G.� -f�x� , ✓ ;Grp .1 r Na of person making statement no Personally wn OR Produced Identificatio Type of Ide i is ' n Produced nk y V (Signature of N ary Public- State of Florida Commission No. (Seal) v Na& of person making statement Personally' own OR Produced Identification Type of Identt#i a iio Produced (Signature of Nota r191J blic- State of Flori a ) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 8/2/17