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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETE'v rOR APPLICATION TO BE ACCEPTED Date: MaNh 5 a019 Permit Number: at Lucie -county � Fon RECEIVED Building Permit ApplicatEB 0 5 2018Planning and Development Services Building and Code Regulation Division ie County, Permitting 2300 Virginia Avenue, Fort Pierce FL.34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: PROPOSED INPROVEMENT LO�CATI N r Address: o��(� i�i9c�r,� ?Cc.\rv\. -,D(- A-�ocj Tier -GC PL 3qq%�- Legal Description:. Dfanq 1p Sprn S'T seeor-i 0MA 61k lob Cd,a3 �69; qaq _ayB5, INl-2101 25(Qa- 1'75q. a'�rs -62407� Property Tax ID #: I (00500030,00 0-, Lot No. � Site Plan Name: Block No. Project Name: Setbacks Front Back: DETAILED, DESCRIPTION OF WO;R Right Side: Left Side: ca.ln � Ul�orto of r�` 1g� t of 31nceIlo erz'�n5 %� i1�gh CONSTRUCTION INFORMATION Additional work to be pertormed under this permit— Check all that apply: _Mechanical _ 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: $ / 00 —6&— Utilities: —Sewer _Septic Building Height: 0 WERAESSEE: ' ' .. , ,CONTRACTOR: Name 30tr6L Z-eaO I e u- Name: Address: 90� 1 -F© ` Gi l fY\ D i2 Company: Address: City: R:)� lef C State: �— Zip Code: a4 189 Fax: City: State: Phone No. * 19 a- 5ig - qq I a Zip Code: Fax: E-Mail: we a 1 or - a od 6-a K166 I , rolw Phone No Fill in fee simple Title Holder on next page ( if different E-Mail from the Owner listed above) State or County License If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAIN INFCiRIt/fAi"ION. •. .' � .. ", DESIGNER ENGINEER: _ Not Applicable / MORTGAGE COMPANY: N p of Applicable Name: _ Address: e. Address: city: State: 15 '" City: `" State: Zip: Phone I I Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable' BONDING COMPANY: Not Applicable Name:,. Name: Address: I Address: City: I City: Zip: Phone: I Zip: Phone: I 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 unl ergoing 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 NoticeII of Commencement may result in your paying twice for improvements to your property. A Notice of Comme 1 cement 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 our Notice of Commencement. �lJ , qSnaJte f Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 'S L-x1 �� COUNTY OF The forgoing instrument was acknowledge before me The forgoing instrument was acknowledged before me this _� day of -y-.Ar— ' 20 N by this day of 20_ by (Name of person acknowledging) (Name of person acknowledging) Notary Public- State Florida (Signature of Notary P lic- State of Florida) (Signature of of ) Personally Known OR Produced ,lc�,ei Personally Known OR Produced Identification Type of IdentificpANNAMARI� ' °SE yp, EGiVENS Produced �4^•:IpN#GG022023 Type of Identification Produced EXPIRES: December 16, 2020 Commission No. eaThruNota�ij underwateF Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR (PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED I DATE COMPLETED I Rev. 7/2014