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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONm � All APPLICABLE INFO MUST BE COMPLE'i cv FOR APPLICATION TO BE ACCEPTED Date: S a Permit Number: • _ �� 7RECEVED uilding Permit ApplicaEion201�Planning and Development Services Building and Code Regulation Division , Permitting 2300 Virginia Avenue, Fort Pierce FL 34982 .r Phone: (772) 462-1553 Fax: (772) 462 1578 Commercial Residential PERMIT APPLICATION FOR: C� Address: 47 "/ 0 Legal Description: S. 101 c-4 /,4Gir" Property Tax ID #: 3�O 33� a0�6-- C30 Site Plan Name: Project Name: Setbacks Front Back: Right Side:. r Left Side: i Lot No._ Block No. Additional work to be pertormed under tnis permit — cnecK all tnat apply: _Mechanical _ Gas Ta I k _ Gas Piping _ Shutters —Windows/Doors _ Electric _ Plumb'ng Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: /� I Sq. Ft. of First Floor: Cost of Construction: $ I. Utilities: —Sewer —Septic Building Height: OWNER/LE:V&ER : CONTRACTOR: Name Lvz& l Address: -S, I n zd'c Q . City: J ; State:�L Zip Code: Fa 1:�i Phone No. 3 6141p 0/ Name: Company: Address: City: State: Zip Code: Fax: Phone No E-Mail E-Mail: h /I J/<- (ghne I, C-0 Fill in fee simple Title Holder on next page ( if different from the Owner listed above) I State or Cou y License If value of construction is 2500 or i ore, a RECORDED Notice of Commencement is required. SUPPLEMENTAL 99PU9TI©N LiEN RW LN -ORIMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ NotApplicable Name: Address: Name: 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 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 commencingfWork or recorcipg yggr 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 3 k . l.oc'�� COUNTY OF The forgoing instrument was acknowledgeq before me The forgoing instrument was acknowledged before me this 'Z^ day of W� ay 20Y% by this ' day of 20_`by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary blic- State of Florida) (Signature of Notary Public- State of Florida ) Persona Ily'Known OR Produced Identification Personally Known OR Produced Identification Type of Identification ,WnVWus 1 Type of Identification Produced V_L. d L_•°:= —n;NpIdIARIEGIVEPIS Produced ,,e ; ,•,, MY COMMISSI0IJ # GG 022023 . Commission No. GXPI1Re.-e54')7ember16,2020 public Undeivniiers Commission No. (Seal) Bonded7hNtyola ry REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE j RECEIVED. DATE COMPLETED :Fe-v-.7/2014