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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONr * ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: J .3© Permit Number: \ JG 0L- G(304 SCANNED • BY i RECEIVED - St Lupie C®u ty Building 1�ermi Applicat on JAN 31 2016 Planning and Development Services Building and Code Regulation Division ST. Lucie County, Permitting 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line 1 ddN �e 'r'Ce Address: Legal Description: PC' 1I6AiI) 1%l*i0 +e Oes+ Lo* Property Tax ID #: .55_9Q--100 - OOD__5'- DOD Site Plan Name: RO61 irmson Project Name: Setbacks Front 0 Back: Right b g _� if Ri Side: Left Side: , qg -C-4- D-V 4-R- %f 1�Vi cl,W W 1 n LA ivn Pao I 0,'Ofv► P 1-:14-) (a) 5:R I,.Stcle, sI'n5JC9oAe_5 Lot No. f Block No. Additional worK to be ertormed under this permit - checK all apply: LIHVAC 11 Gas Tank ❑Gas Piping Shutters a Windows/Doors 11 Electric 0 Plumbing Sprinklers 11 Generator Roof Roof,pitch Total Sq. Ft of Construction: Sci. Ft. of First Floor: Cost of Construction: $ '7700 Utilities: Sewer O Septic Building Height: jj��+^�'» � }\A,'a(ur�`}}'.�� .r h� 'd P e$ "Y `t +�' � ✓#' i' ANl j�/,4M '� ,_ N ad�..^Ik, fs!bl�Jk k fi: bCCINTIACT01Z 6(/� # l�w'i'4 "h i '� Yu "t 9 ' `xk / d d: n>^ .$'d'-6%; av_f 'Tma§ . -:.._< L? re � ...,,.:. �. _ , � 4 '� . _ > �'' -� �€e � >ii "Q�= ,.� - = �,. >:. i�zR.�, ➢', Name f' Name: Address: I EMeI�0. & e Dv- '-�£- Company: 51,^f f'ea�C� GDI'Y� City: (iy\ 0,cm,54- State: Address:�� IJQ� 02(o3�p City: i`IU,% + State:_E_L_ Zip Code: 30-13 7 Fax: Phone No. Zip Code:.3*495 Fax:'Y'ia-oi$S'3035' E-Mail: Phone No. firf a - 9�lS - J f / Fill in fee simple Title Holder on next page ( if different E-Mail: 54up_r+4Z^ce—QbcI %h e+ State or County License: 20 F'ye from the Owner listed above) If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. 1 SUPP M111 NNW ENTAL COISTRUCT IQL NW1NF.0 iVfAl4�� vl DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: 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 inspec ' . If you intend to obtain financing, consult with nder or ttorney before commenci qo6cording yourNotice of Commencement. Signature of Owner/ Lessee/ContractoIV as Agent for Owner Signature of Contractor/License Holder / STATE OF FLORIDA STATE OF FLORIDA COUNTY OFF( n COUNTY OF The forgQ*ng instr ment was acknowledged before me this' day of 20 by The for Ing instrument was acknowledged efore me this ay of JCL4 LLCLV—[.� , 20� by ch ez4v-i Name of person making statement Name of person making statement Personally Known ✓ OR Produced Identification Personally Known Pf OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Notary #-Fleri (Sig ature of ota P?Ly �lic- Stay}�p7 orl a DIANpE K BOND �yF I VE0 K OND :•. Commission No. MY CONiTJ11�111ON #FF185430 Commission N '- MY COMMISSN �185430 IO !3 -.s..........�� EXPIRES December 28, 2018 -rFOF;` EXPIRES December 28, 2018 „, 407 398-0103 Florldallota Sarvice,com (407) 398.0153 FlorldaNatr�rySctNlab,Bont1 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED tev. 8/2/17