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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL A "�' PLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED DateI ZLI l I�3 Permit Number: %4 a� - a6a� SCANNED IL BY RECEIVED B�i�i�c�i'r�g�'`mit Application JUL 2 4 201� Plane ing and Development Services Buil ing and Code Regulation Division ST. Lucie County, PernSittin 230 Virginia Avenue, Fort Pierce FL 34982 Ph ne: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PER�''MIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line 5�'{� ,PR ,POSED IMPROVEMENT LQCATION: I n I- ,n -1 n I. 1 in A IT n _ _ ' i . • . / � n. 1 Legal' Description: lmwdi �ijV(S(�iC.SNv� l- t�E3t S h�1 lSL ( PB �� Z S•18 ac, 2 t��l s r o Z- 5�v Pro ertyTax ID #: Z32q - r;oZ - b0p Z - 600 - ( Lot No. 2 Site'�lan Name: Block No. Project Name: C OMNSTRUCTION INFORMATION: Ai,ditional work to be neffo-rined under this permit —check all apply: I _ HVAC Gas Tank ❑Gas Piping _ Shutters Q Windows/Doors X Electric © Plumbing Sprinklers Generator Roof I Roof pitch T tal Sq. Ft of Construction: —ter S . Ft. of First Floor: C'Ist of Construction: $ �J3�I OC70 2 Utilities. Sewer Septic Building Height: �v OWNER/LESSEE:` 0. T Name dress: 3110 eVS KOOLC� 1ty: i--gol e�( ei State: R dip Code: 3y Q I Fax: hone No. -112 - 5 - oo q 2 ame: ayIA,-s 1 re eA rV V- Company: 1 re f ejrneV Cis u L�'Lw� In c Address: 1-1(90 NKY\YIQ 4 f* e . City: F�2�i P 1 �2 State: Zip Code: Fax: -Mail: fIII in fee simple Title Holder on next page ( if different I•om the Owner listed above) Phone No. -1?, 201 1833 E-Mail: - eT 6 vitV Qh oo 1 COS State or County License: elm k3S `N value of construction is $2500 or more, a RECORDED Notice of Commencement is required. (� oa3 SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESI NER ENGINEER: Not Applicable MORTGAGE COMPANY: _ Not Applicable Nam�'� ax \ R a el\ 0. Name: Addr 'ss• 13-� Sq G-T n�a AOE, Address: City: i QoV-fi C}, to r ►,e State: 1 City: State: Zip: 33LA 'Z Phone 'Vla • -2"11- 2 457 Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: Addr ss: Address: City: I city: Zip: 11 Phone: Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. I certi that no work or installation has commenced prior to the issuance of a permit. St. Luc a County makes no representation that is granting a permit will authorize the permit holder to build the subject structure which s In conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such struct�11 're. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In con$$,ideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work in acc¢Irdance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. The follllowing 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 WA WING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for impr''vements to your property. A Notice of Commencement must be recorded and posted on the jobsite befo'le the first inspection. If you intend to obtain financing, consult with lender or an attorney before rnmmanrina vunrle nr rprnrrUna vnl Ir NntirP of rnmmPnramPnt- A J� Sig latur f Owner/ Les /Contractor as Agent for Owner Signatur Contract cense Holder ST�►TE OF FLORIDA )r- STATE OF FLORI A , 'fit.''y c�k COUNTY OF 3 �--ro c��. COUNTY OF Th it forgoing instrument was acknowledgpj before me The forgoing instrument was acknowledge before me Zk ' "Tv\4 thi a."1.day of � 0\�1 , 20by this day of , 20jI by Name of person making statement Name of person making statement P r1sonally Known OR Produced Identification Personally Known OR Produced Identification T pe of Identification `cc $. Type of Identific tion ��- t— Pr11' ed 0 �- Produced �Pf.4Rlr AavU Rnrr,.`'1i9 ( ignature of Nota : ___ublic State=of Florida) __. ' - il UIVL'lil �fi� F ��`�,CLNr'� �'1Oi41 t Gv' (Signature of Nota Pub11c1State o�F,lgr@al`)' -v# GG 0; ??O' Ai OFF�O..` J. l.rrember ru Floiik eiY P•'bl"c Urndenw G� C, mmission.No: " _ 1 (5ga�) 1a, Commission No.alffi p ���(Seal)__ EXPIKe�: Uw;cmbar {j4 .t'''"1 i'•'�^ I'ICl �4f IlG ilit'.°ieRtiii `. n�1' • `"'��e"�'�:.� i BondedThru _;; ;, REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW ATE RECEIVED 'ATE OMPLETED . 8/2/17