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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETEf,,� APPLICATION TO BE ACCEPTED Date: 7i7_2-1 Permit Number: o d (zGto -� ICA1W J RECEIVED _ - = �Y •- JAN 2 9 2018 Building Permit Application Planning and Development Services ST, Lucie CounlY# Rftittin g Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 / Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR! ' # 1i!j ," ,' Y 'l 7��S "n` � ..►.+ i'» 4'..,9 :YS©. .xa i:�n ,�{�'9s`. ..zll Sox Address: S 4 it 1`� 10�. Legal Description: kv,�� 1% Property Tax ID #: V31 Z `0 Site Plan Name: Akajrw Rut, Project Name: Setbacks Front Back: Right Side: Left Side: _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Electric _ Plumbing _ Sprinklers _ Generator Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ 404. Utilities: —Sewer —Septic Lot No.� Block No. _ Windows/Doors Z'Roof .SI�Z rL Building Height: to "d $��"�S--1� {•,v ....�3i s .F"z: �' - SSC-i.±'. ,, b( w4.-s-.'7, �:G1u} .>,. r"j^,! ak se-5'£ ors, e. �osa, i.f N ,`.+CL. y.1'i. .,F ,nixie' .�4N; .. t _-� �� ��� ,tlrtrn.� :'% . Me.�f7 ' "� %e�`v .! .4� ��.� d_'i �`�' Name LS p.1. Name: Company: Address: 5106 Cliff a, City: 1;Mce_., State:TL. Address` Zip Code:3LkA.5k Fax: City: V%4 State 7 Phone No. -�'�'" ZipCode: Fax:7TZ 3S-� E-Mail: Phone No -7 7 �� Fill in fee simple Title Holder on next page ( if different E-Mail S em d ilaPJ from the Owner listed above) State or Cou y License «L OS % 3( 6 If value of construction is 2500 or more, a RECORDED Notice of Commencement is regt4red. y}, °'t 'w'"iYt �.. "Y A*+';�.%+6'e+• t1 �. "+. Y�fNf�)...�be.9* dhr`�.���*C 4('�,jF+�, 't"d{d�Yi{ �i!"�$� t �"d�5`i� s `Y �a�k_9i '°'6,2'ak Ra, ,ti �4c :tSx>- r a L'X„4SSS..Y`.i'e^T-''?Flya1fiti".s:r�`i,�3+C��,?�Y?'v. ..Y2�2..:!'Fn `.'% ` ti�`j�a 't �gk1%�,pPAC _-`�i.•i ,q DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLEHOLDER: 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 inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording your Notice of Commencement. Lessee/Agent of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF ��9 G. COUNTY OF c Lu Lc-2-, The forgoing instrument was acknowledged —before me this�day o &� i . 20 Personally Known `a OR Produced Identification Type of Identification Produced ,.M. "JAIME ORTIZ �� RY PV Notary Public -State of F Commission NoV� k t 1 Q�e k`Comm. Expires Jun 1, ommission # FF 111 �''�O�°� Bonded Through National Notai REVIEWS I FRONT COUNTER COMPLETED The forgoing instr ment was acknowledged efore me this ay ofGV 20by (Name of per, on acknowledging) (Sig P re o�fary lic- S e of Florida ) Penally Known OR Produced Identification. )e of Identification gortinission No.�� Assn. JAIME 0 T Notary Public - Stit( 1 Floric My Comm. Expire J 1 1, 201 Commission # FF 11485 Bonded Through Natic ial lotary As ZONING REVIEW I S UPERVISREVIEWOR I REVI W I VEGETATIEV EWON I SIATURTEV EWLE I ME EWVE