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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION 7-30-18ALL AP,1�LICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED � Date:lll SGANNE® Permit Number: \%t3^l _d oQp 1 . _ BY Emote St. Ludis Counw, Building Permit Application Planri g and Development Services Jul a 0 Builds g and Code Regulation Division ST. Lucie County, Permitting 2300 I�irginia 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: V3 45.56 N e::�V.% Tz>U Legal Description: t'3gC S ��„c, _ C��QrP.Cc� \'3�kC �i— Prope I�ty Tax ID #: 1-k Via— —� �'bQO� cam- Lot No. Site IN In Name: k,-Ye�\_tz SSA Block No. Profec� Name: Setb4ks Front Back: Right Side: Left Side: DET 'ICED DESCRIPTION OF WORK: CONSTRUCTION INFORMATION: Addil ona wor to je ne orme under this permit — check a apply: L_ EHVAC J Gas Tank Gas Piping _ Shutters a Windows/Doors 11 Electric F]Plumbing Sprinklers FIGenerator E]Roof Roof pitch Total Cost I. Ft of Construction: Construction: $ S Ft. of First Floor: _ Utilities:i Sewer O Septic Building Height: :OW i ERAESSEE: CONTRACTOR: OC Nam of Name: 0 eeL • Sm,. Addr ssy�°1,% ),je�L4S Cit . �Qr.�S2u� X� State: k `- Y' �/��f r Zip q de: Fax: Company: ��r0 Address © ^" r Zf�Ot' L� City: <<<ot 00 Stater Phony No. Zip Code: f yC Fax: Zn— a14 1"f2r-Z- Phone No. 772 — y61— f 2 2 L E-M il: fee simple Title Holder on next page ( if different Fill ir E-Mail: 49 Cow State or County License: 6&0012! 66 from'; he Owner listed above) If vale of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESI NER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable Nam': O`A�� c.4%.•c.e_C-'wSY _ Name: Addr s s .1,SJ w S rwc, Address: City: b Q.e�c, State:Tr--- City: State: Zip: "l Phone Zip: Phone: FEE S MPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable Nam _ Name: Addr Address: " ss: City: City: Phone: Zip: Phone: Zip: J1 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. Luci which i' County makes no representation that is granting a permit will authorize the permit holder to build the subject structure in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structu' . Please consult with your Home Owners Association and review your deed for any restrictions which may apply. In consi lu eration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work in accor ance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. The foll wing building permit applications are exempt from undergoing a full concurrency review: room additions, accessc structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use WARA ING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for impro cements to your property. A Notice of Commencement must be recorded and posted on the jobsite beforE I�the first inspection. If you intend to obtain financing, consult with lender or an attorney before comm' ncin work or recording our Notice of Commencement. Signa' re of Owner/ ssee/Contr or as Agent for Owner Signature of'Contractor/License Holder STA � OF FLORIDA STATE OF FLORIDA COL TY OF `3� hac.�t. COUNTY OF The fol' II ping ins ment was acknowledged before me The fo ing instrument was acknowledge�efore me this ay of 20��by thisday of 20� by Name of person mng stat ment Name of person making statement ✓OR Perso ally Known ✓ OR Produced Identification If Personally Known Produced Identification Type Identification Type of Identification Produce Produced (Sign4 ure of Notary' (Signature of Notary-P-ubli�t�a>e of lotida ) Com ,a��"��„ STELLA M. HUNTER %%vAay P& ..,�, scion No. :ter°. =_ Nolan ubll� - State of Florida ""'�� : `O'.�PRV PG'•,�i STELLA M. , f 'a R Commission No _! 2LL Public -Sty • . . •= Commission # FF 180552 My Comm. Expires Jan 23, 2019 _ o Florida 9• Q Commission # FF 180552 .o,• MY Comm. Randprithroug atlonal NotaryAssn. ko� ;o;.� Expires Jan 23, 201 a oval N ary Assn. REV WS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TU TLf ROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEI; ED , DATE COM LETED Rev. 8/ 17