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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR Date: St i )PLICATION TO BE ACCEPTED. 'Q 2 Permit Number: BANNED BY ide County Bdilding Permit Application RECEIVED Planning and Development Services MAR 12, 1018 Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Permitting Department Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential �4 St' Lucie County PERMIT APPLICATION FOR: j,),NC96La -rL)Mr ./p PROPOSED INPROVEMENT.LoCA ibO A Address: 117 QO&C-tm CA�'/4EYK/niA GT r nn.-r Pi _ r � 3Y,719, Legal Description: I OWNER/CESSE. g ... . CONTRACTOR. e Name M6r-,l.0 -rul \ ry-\ I ri 8 Name: �. S. ill DOS G Lz`GT2/C, [.LC Address: l ! % QVG(%N Cog 7yc'21NA C 1 Company: Glut% s, M OO/L.c City: f'- O&T 10(EAC C. I State: FL Address: 1 S E - 1419" V /L 991 vim/ NIP Zip Code: �Ll(?y9 Fax: N /Z City: V S:A' Kish State: re_ Phone No. 7 O 1 " 5 ee - 5850 26/7-0 Zip Code: ✓ z 960 Fax: 7 %z - %qy` 2 y39 E-Mail: /VhA I Phone No -7 7 Z - 6 q ` q6i y/ Fill in fee simple Title Holder on next plage ( if different E-Mail oj! 666N COt% CAS 'T. N ! T from the Owner listed above) I o State or County License EC / 3 OL Z Z if value of construction is 2500 or more, a RECORDED Notice of Commencement is required. r14 i SU'PPL,EMfNTAL CNSTRUCTlON L1EN t.AW tNFORMATtQV. nsag• -d. `."' 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 themork 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 per 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 our Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instrument was acknowledged before me, The forgoing instrument was acknowledged before me this day of 20_ by this day of 20_ by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Public- State 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 COMPLETED " ev. 7/2014 0r, LUC.— c­1 DESIGNER/ENGINEER: App Name: Address: City: State. Zip: Phone FEE SIMPLE TITLE HOLDER Name: Address: City: Zip: Phone:_ e MORTGAGE COMPANY: 'bS Not Applicable -Name:. _ _ Address: City: State: Zip:, Phone: X--Not Applicable I BONDING COMPANY: Not Applicable Name:_ 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 Ass patron 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, 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 frofn undergoing a full concurrency review: room additions, accessory structures, swimming pools, fences, walls, sign , 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 obta n financing, consult with lender or an attorney before _ commencingwork or recordingour Notice of Commencement. ..d' •i�.0 J . %ne-� Signature of wner/ Lessee/Contractor as Agent for O ner Signaf Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA�. COUNTY OF COUNTY OF cc����nn ��� The forgqing instrum93.twas acknowledged before me The for o'ng instrum-ent-was acknowledged before me thisay of Idm 20/1 by thisay of—.,IaWt . . 20/' by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Public- State f Florida) (Signature of Notary Public- Sta& of Florida ) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identifica ' Type of Identific ion Produced •itSSK?"'''• SURGEON Produced 1MUM! MSURGEON ;� MY COMMISSION # GG 13.6489 Commission No. :; P: EXPIRES;Ar(Y)3,2021 �jt {,, s, i MY COMMISSION #�GZ; 89 Commission No. r•= RES;Augu , '' ' •'F.F`••'' Bonded Thru Notary Public Underwrite �,,ok ft`p'', Bonded Thru Notary Public Underwrliere REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE 'MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 7/2014 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: Building Permit Application 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 Residential r PERMIT APPLICATION FOR: Address: Legal Description: I i Property Tax ID #: Lot No._ Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: _rvic%.naniI-ai _ UclD 1 ai.in _ %Ja� rINn ig _ J1 FULLCI a _ V V n °uuwal vUWJ a _ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: i Sq. Ft. of First Floor: Cost of Construction: $ Utilities: —Sewer —Septic Building Height: . P�iR/i�SSE: 00 CTQ g Name (, __._ --- • --•--- �r•. �--;------ - i . Name: __ . .. .. •,, .,<;. Address Company rc2 : f `.,' .— City: > �_` ` ° State: Address�� _ ZipCode: Fax: City: Y• State: — Phone No. Phone Zip Code: Fax: E-Mail: Phone No Fill in fee simple Title Holder on next page ( if different E-Mail from the,Owner listed above) State or County License IIIf value of construction is 2500;or more, a RECORDED Notice of Commencement is required.