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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONA All ALABLE O MUSTBE COMPLE'r,-,, FOR APPLICATION TO BE ACCEPTEDDat Permit Number: Fas- once SCANNED l- y RECEIVED, St Luce �ie1)ni°E � Building Permit ApplicatiLnMAR 05 2018Planning and Development Services :,RECEIVED ie County, Permltt)ng Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential Address: _,) -V Legal Description: Property Tax ID #: �7� ©oZ • / D�o�� • (/ �" Lot No. Site Plan Name: Block No. Project Name: etback"s", Front ck: Right Side: Left Side: — Additional work to be pertormed under tnis permit — cnecK an tnat apply: _Mechanical _ Gas Tank _ Gas Piping —Shutters, , i Electric _ Plumbing _ Sprinklers _ Generator Total-Sq. Ft of Construction: _ Sq. Ft. of First Floor: Cost of Construction: $ / l% 0 • Utilities: _ Sewer _ Septic Name "A e. (L• Name: Address: / Company: City: i /C. State: Address: Zip Code: Fax: City: Phone No. ~% -37 D'7 Zip Code: E-Mail: Phone No Fill in fee simple Title Holder on next page ( if different`s{ ' E-Mail from the Owner listed above) State or County License Windows/Doors Roof Pitch Building Height: Fax: State: If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. I I 2.2 xIX III nqg'� � ` Lgimy 1 `AL;�� NSTRU10 ION LIEN, LAIN INE'ORMATI�N 4 iYT?Vi n Mndii",4 s YLi'�r,r.�vi�J�,� ..F .:cl_ t._ __ js� �� . i I;. !_�.� �i_. ....i �_„ :�... ii., _ .. ..�u . ,_,. �., ..�:..... .. . ���. ...._ �.. .. �. !:.. �' . I DESIGNER/ENGIN ER:' Not Applicable Name: 55� 9 5 MORTGAGE COMPANY: _ Not Applicable Name: Addres •%° � �c/i V.Address: City: State: City: `rA.e I & Stal e: L Zip: 1 0 Phone S ���f' 'yel I 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 inspection. If you intend to obtain"financing, consult with lender or an attgrney'before commencing w recording our Notice of Commencement. S re of Owner/ Lessee/Contractor as Agen for Owner, Signature of Contractor/License Holder STATE OF FLORIDA ='" y' ._ STATE OF FLORIDA COUNTY OF _�` `::.:., COUNTY OF The fcAgpg instr t as acknowledged before i The forgoing instrument was acknowledged before me this,gfA day of 20%by a Xc-� a, T 17p c lip this day of 20_ by 2 � s m M J Qm (Name of person acknowledging) 3T �T (Name of person acknowledging ) C = � N (Signature of Not y ublic- ate of Florida) (Signature of Notary Public State of Florida ) Personally Known ' OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced Commission No. (Seal) Commission No.(Seal). , ' , REVIEWS FRONT ZONING SUPERVISOR PLANS .:VEGETATION SEATURTLE, ',.MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE q� COMPLETED lid ev.