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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTS-&--' Permit Number: 0*0 ANNW BY I RECEIVED . 2018 Building Permit Application PermittingLUQIpe St. count, Planing and Development Services e t, euil ing and Code Regulation Division 23001iiVirginia Avenue, Fort Pierce FL 34982 Phonl f: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential _ PERMIT APPLICATION FOR: '5®t4 b�IR P-WJ WL�vE Addr-es"� � Legal Description: P-72p yTax i! l 3 1 3 O a© 0 L19 000 5' Lot No. Site Pla n Name: Block No. �I Projectame: SetbacK Fron a Back: i�f Right Side: � Left Side ;III r6AX-(' 14 x 1 V Co 0 C(I-E 7c Addition'8I work to be pertormed under this permit - cneck all tnat apply: _Mel1hanical _ Gas Tank —Gas Piping —Shutters--* / I, Windows Doors•-- _ Ele�lll ric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total of Construction: Sq. Ft. of First Floor: 90099R9, lltr .. n: Utilities: —Sewer _Septic Building Height: OWNER/EWSREFE: CONTRACTOR: l ame I11,� ) I L C %" F/LRn1 �11-r LP- Address:-II� S-01 y b em (L,­,y Wive ity: 40- Q (CYZCi` State: f'L Zip Code� 3 Y Fax: Phone Noel `i 2 -2 3- 1 S U 3 7 Name: Company: Address' City: State: Zip Code: Fax:. p Phone No i E-Mail: yil 1'r � /% c-J e- W h LIz-il S Fill in fee I$imple Title Holder on next page ( if different om the IlOwner listed above) E-Mail = State or County License If value of c6pstruction is 2500 or more, a RECORDED Notice of Commencement is required. SUPPLE ENTAL CGINSTR CTI(d3N LIEN NFL RMATION: DESIGNER/ENGINEER: Name: Address: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable ' Name: y. I Address: I I City: State: Ii Zip: Phone: I.! City: State: Zip: Phone FEE -SIMPLE TITLE HOLDER: Name: Address: City: Zip: Phone: _ Not Applicable 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 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 commencing work or recording your Notice of Commencement. W Signature of Ownery Le see/Contractor as Agen for Owner Signature Contractor/License Holder of STATE OF FLORIDA STATE OF FLORIDA i COUNTY OF dg 1 COUNTY OF The or oing instrument was acknowledged before me The forgoing instrument was acknowledged before me this . day of 20M by 0AA this day of 20_ by (Name of person acknowledging) 4gnatture (Name of person acknowledging ) of Notary Public- Ate of Florida) (Signature of Notary Public- State of Florida ) Personally Known OR Produced Identificationy Personally Known OR Produced Identification Type of IdenDfication Type of Identification Produced Produced Commission No. 5+''� " ��(SgNI)hIAHNAINGRAM Commission No. (Seal) curt "I", Notary Public State of Florida REVIEWS - =".X.1 FRON ':'� omm s�i�q# FF 177249 4U,.�tgR�Js.qgs n.PLANS VEGETATION SEATURTLE MANGROVE COUNT dedthr 5P REVIEW EVIEW REVIEW REVIEW REVIEW DATE Z RECEIVED J DATE COMPLETED ev.