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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICA ION TO BE ACCEPTED Date: CS �� /( 000 3nJJ Permit Number: �O3- d 500 RECEIVED _ 09N V0 Building Permit Application MAR Planning and Development Services ST. Lucie County, Permitting 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: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: 3260 al Ce, Legal Description: Pop .:/ =� el+ "e '�L�' S 2'-cue?, f�itiu C e- Il � i : IaLS �; � I u 1,4 0, l d,- / 7 /-IlT 3�L Property Tax ID#: °�3��/- SOO-' 00I22) 000 —% Lot No. Site Plan Name: I Block No. Project Name: Setbacks Front Back: 6 3, 5-0 Right Side: �� �� Left Side: 3 2.5 I DETAILED DESCRIPTION OF WORK: iJ y'r,5��111`•nG� Soo 64/lvn Qiqane_ 4—r k creA run4;.-? lr rtPs �o gP►�efa� d,� , r CONSTRUCTION INFORMATION:/' Additional wor to be pertormed un ert is permit - check all apply: �HVAC Tank ZGas Piping Shutters a Windows/Doors _Gas _ Electric El Plumbing 0 Sprinklers ElGenerator Roof Roof pitch Total Sq. Ft of Construction: S . Ft. of First Floor: Cost of Construction: $ �, 000, `I' Utilities. Septic Building Height: I OWNER/LESSEE: i CONTRACTOR: Name C,6dles + "jL6 -i-i ne_ 18u,(AP44 Name:^ YI I" _ ewe _ Address: 9900 ©ne- P(,4+1 Plaice, Company: QL City: State: _ Address: - )5 70 �3 --ICJ My �i r", Zip Code: Fax: City: .Tin Gl / 2 H, 4Q G0,/'N State: Phone No. Zip Code: .3 Y Fax: 77.)�-597- 5 i3 E-Mail: Phone No. ,) - � 9 Fill in fee simple Title Holder on next page ( if different E-Mail: : i i9y !n 742 1 ✓License: ,'Y / y State or County from the Owner listed above)' If value of construction is $250 or more, a RECORDED Notice of Commencement is required. -�)6 4o G ip f SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: I Address: City: State: I City: State: Zip: Phone I Zip: Phone: I FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable Name: Name: Address: I Address: City: I City: Zip: Phone: I Zip: Phone: I 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 commencine work or recordine vour Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA In a 1-4 i COUNTY OF /Y)a 1-4; n COUNTY OF rl The forgoing instrument was acknowledged bl fore me The forgoing instrument was acknowledged before me this 11�� day of Mat,(-k , 20 l K by this 1(df'h day of -iA�'t , 20 �$ by �y1ieL Co\f _DaNle4 Co- Name of person making statement) Name of person making statement Personally Known ✓✓ OR Produced Identification Personally Known ✓ OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Notary Public- State of Florida) (Signature of Notary Public -State of Florida ) II Commission No. tSea1tHRISMNEE.SCHULER mission No. r-1= q 20q l MY COMMISSION I FF OMI • ; ";_� �' _(Sea7)IRISANNEE.SCHULM .: : r__ MY COMMISSION I FF 92091 EXPIRES: January 19, 20 ry EXPIRES: January 19, 202 'r',.• 7 . .d* : a„_ Bonded Thro Notary Pubk Unde REVIEWS FRONT PLANS VEGETATION SEATURTLE MANGROVE ZONING SUPERVISOR COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED I Rev. 8/2/17