HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a \ a� 1 �' Permit Number: \4oa' ci ao
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SCANNED
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Building Permit Applicati n
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
A
FEB 2 8 4"018
ST. Lucie County, Permitting
Residential -
Address: LG�,�
Legal Description:13 (0 T" qT' QIAQU I- IA G S%kl3q,�A 1 M CIP, Z C)
Ig214. Ps-T14*;Lj'Du.r=.1 IN—" N(®a\.'k Av. -c;•7--I\&4) na"t,]*k--'JQIf
Property Tax ID #:
Site Plan Name: Y-� bc--f-ca-
Project Name: VAZ12)C-0-00
Setbacks Front Back:
DETAILED D'E�SCRI� ° `fl �N ® WORK:
jv►�y 5�C) G,a L
Right Side:
Left Side:
- . . . .. • . , 1 . "I .
Lot No. I"+
Block No. i
_Mechanical
Gas Tank'- ---I
_-,Gas Piping _ Shutters + ' '
= Windows/Doors
Electric
Plumbing
Sprinklers Generator
Roof
_
_
i�ti f fr, /
_
Total;Sq!:FX;Qf Construction:
•
.''lt .'
Floor-,•
'•j � !s � i t.',"fin . �r!'.•
6dst'.ofConstruction: $
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5806.
,.�, e .� _r ,j.� �%'... •
V f.
Utilities: k l Sewer,:,;°'
:�` `Septic
Building Height:
1OVNE'R/LASS
�ON'TRACTOR:
Name-KL6-Z5tPqr Vk*,eM AW4-
Address:.�; '�-% 7 bgkkE
State I—
Alcidress + i% ,���'�IJ vo M E 0.G'E. Nvi;�
:
%rZip Code9 5 Fax:
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City: Stag �—
r,�,
Phone No. 7 Q +64 -7 X:;3'
Zip Code: 32.9 Z 0 Fax:
E-Mail: Kft V4-L%R=EA (-r 4 QS Mid 1t-• % �A
Phone No jl%.;L
Fill in fee simple Title Holder on next page ( if different
E-Mail VJ I 1 t
from the Owner listed above)
State or County License
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applicable)
Name: &N
Address:
City: State:
Zip: Phone
FEE SIMPLE TILE HOLDER: _ Not Applicable
Name: ii''�t11
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: — Not Applicable
Name: NIA
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name: Q d
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 Y ants that may restricty rprohibit such
structure. Please consult with your Home Owners Association and review our deed for an 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 f tom 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 al 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 yeu intend to obtain financing, consult with lender or an attorney before
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Signatur f Owner/ Lessee/Contractor&s Agent forl Owner
Signature of Contractor/Lice e HdIder
STATE OF FLORIDA
COUNTY OF .5� L Vrai I
STATE OF FI ^"" "
COUNTY O' S � •
The forgoing instrument was acknowledged before' me
The for oing instrument was acknowledged before me
SAwAAgd 20A by
this � day of bPtia N-/ . 20J qby
this day of
decL-fl L_ ecAokd I
on L. At-c ieAd`!
(Nam person acknowledging) I
(Name of pe son acknowledging)
\\ L;NICht7
nature of NotaryPublic- State of FI da • o� N y
i nature of Notary Public- ate of Florida)\���\1 L. N/
Personally Known OR Produ(IdAlctenti ication '!
isrsonall Known OR Produced Icl �tific.� ' MMlssip�'.•
Y
Type of Identi cation - �'.
• :s 061770
Lee
8pe of Identification $ �P
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Produced em G,� ;off a g:
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Commission No.�� �7� �o n0
Commission No. ••......• \
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STATE 0 Fv
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REVIEWS
FRONT
COUNTER
ZONING I
REVIEW I
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
REVIEW
DATE
i
RECEIVED
DATE
COMPLETED
Rev. 7/ 014