HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APF
Date:
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INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ` ��'
(D �- Permit Number: V (�
SCANNED""IVE1
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BY RUM
St. Lucie Owmfy
FMAW Building Permit Applicatio JUN 4.
6 2018
Planning and Development Services
Permitting DepartmE
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie O.0 ntyr . F
Phone: (772)1462-1553 Fax: (772) 462-1578 Commercial Residen Ia
PERMIT APPLICATION FOR:.—�--
Address: % 2. '/ ,/
��G- �.�c c_�n 1 L495 I'"
Legal Description: ' u M r �I i° dl'c -r— 4-6-G .S e-<z
it z co �r !f(:4_ 1
Property Tax ID; #: Lf'�)1 l l b b 'l 2 oo Lot No. 1 I
Site Plan Name: Block NoJ - E YZ
Project Name:.
Setbacks Front Back: Right Side: Left Side:
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t" " D e . , �'r-rl. tyl 0��
Additional work to be pertormed under this permit- cnecK, airttnat apply:
_Mechanical _ Gas Tank Gas Piping _ Shutters. - Windows/Doors,
—Electric i; —Plumbing —Sprinklers _Generator 1/Roof Pitch
Total Sq. Ft.of Construction: Z`ZZ3 Sq. Ft. of First -Floor: r'
Cost of Construction: $ co Utilities: _ Sewer Septic Building Height:
Name ` C�c c. A 'F-AV,S
Address:yz, F_
City: \c.� State: I
Zip Code: 3 3 \' k.P,O Fax:
Phone No. bt) ' J- 5-6—/ e C
E-Mail: I Al 11
Fill in fee simpie Title Holder on next page ( if different
from the Owner listed above)
Name: ✓1 Company:
Address:
e
Addres//s77: ZL�Ce Z Si . rpa,[
City: o'�✓ f Sl , L c.� c '� State:
Zip Code: 3 �4�Sr Z Fax: cy/�
Phone No --7 2
E-Mail
State or County License
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If value of cons*uction is 2500 or more, a.REWRDED Notice of Commencement is required.
DESIGNER/ENGINEER:. _ Not Applicable MORTGAGE
Name:.... ,-It
Addresi:
;City'' _ ...., State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable.
,Name: --
Ad dress:
City:
Zip: Phone:
Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COM
Name:
Address:
City:
Zip: Phone:
Not Applicable
OWNER/.CONTRACTOR'AFFIDVIT: Application is hereby made to obtain'a'permlt 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 befor
commencing work or recording your Notice of Commencement.
Signature of Owner/ Le ee/Contractor as Agent f
iE¢'1Rge
Signature of Contractor/License Holder
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STATE OF FLOR r
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COUNTY OF
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The f Qing ins u ent was acknowledged efor
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The:f r oing instr nt was acknowledge efore E,.,-v
thi� day of 20LYby
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(Name of person acknowledging)
'��t�''
(Name of person acknowledging)
.(Signature of N CY ry Public- State of Florid )
(Signature of Nota ublic- 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
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW.
REVIEW
REVIEW
;REVIEW
DATE
r�
RECEIVED
(i ;
DATE
COMPLETED
Rev. 7/2014