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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL PPLICABLE INFO MUST BE COMPLETED -FOR APPLICATION TO BE ACCEPTED Da le: SCANNF-D Permit Number: VU BY St. Ludy(Cou,71tv RECEIVED Building Permit Application 7dinigand evelopment Services J U L 3 0 2018 de Regulation Division ST. Lucle County, Parmittin! venue, Fort Pierce FL 34982 -- - P ne: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PE MIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line i _FR . . POSED: IMPROVEMENT LOCATION: Ad ess: IU 3 %- Qe(P - V 1'% r (7N Q Leg I Description: I) 3 S- •3c( from NW Cf Ale- 1 /Ll (zJn W t10-6- }) G.) (l/tj Cvp berty Tax ID #: 06M — 000 A Lot No. Plan Name: Block No. ect Name: backs Front Back: Right Side: Left Side: TAI LED bESCRfPTION' OF,INORK: C NSTRUCTIONANFORMATI;ON itiona wor to e e orme under this permit- check a apply: pHVAC E] Gas Tank ❑Gas Piping _ Shutters Q Windows/Doors Electric 0 Plumbing Sprinklers Generator © Roof I2- Roof pitch To dal Sq. Ft of Construction: /�yd • C%� S . Ft. of First Floor:' i C t of Construction: $ �OC10 , 00 Utilities: Sewer []Septic Building Height: dl O ,NER/LESSEE. ; .. CONTRACTOR: N me („f i ( rGam-S Name: M ,- I►-S L)C�9-tom A dress: 111.3 C- CcjVet kwVY A d Company: B ('Gv� r, ,o) a, (, CilI,y: f�=f• Pmrc& State: rI A Address:.3609 �W 'Ole) kJt i City: Son (� �S State: r I Zj Code: 3 Ll C? tl � Fax: P II one No. Zip Code: 333 S' ( Fax: Mail: jC Phone No. FiI I in fee simple TitYe Holder on next page ( if different E-Mail: f 11 m the Owner listed above) State or County License: of construction is $2500 or more, a RECORDED Notice of Commencement is required. r I . z- ;SU PLEMENTAL CONSTRUCTION U N .,LAW INFORMATION: DE 'IGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable Na e: Ad ress: Cit State: Name: Address: City: State: Zip Phone Zip: Phone: FE9 SIMPLE TITLEHOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Na e: Ad ress: Name: Address: City: Cit, Zip: Phone: Zip Phone: OW ER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. Ice fy that no work or installation has commenced prior to the issuance of a permit. St. LIcle 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 coilpsideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work in ac ordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. The Ilowing building permit applications are exempt from undergoing a full concurrency review: room additions, acce sory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use WA' NING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for imps ovements to your property. A Notice of Commencement must be recorded and posted on the jobsite bef�re the first inspection. If you intend to obtain financing, consult with lender or an attorney before com, mencing work or recording your Notice of Commencement. of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder OF FLORIDA STATE OF FLORIDA rY OF 5i . Lu_e 1 2 ICOUNTYOF- _,5-f L ae- e- Th"g forgoing instrument was acknowledged before me th� day of 2018 by Name of pers making statement orally Known OR Produced Identification of Id�jtification �1 uced' I / gnature of Notary Public- State of Florida ) mmission pea eye;., DEE D. SOOP (Seal) omm ssion # GG 151925 Expires November 18, 2021 EWS IFRONT I ZONING COUNTER REVIEW IVIED 8/2/17 The forgoing instrument was acknowledged before me this _/a day of r l jq 20f, by Name of person making statement Personally Known OR Produced Identification Type of Identification Produced iLC_; (Signature of Not •4�^.Y?!mac ; DEE D. SOOP Commission No. mmi9si6n#G��5 Expires November 18, 2021r Bonded Tfiru Troy Fain Insurance 800.385.7019 SUPERVISREVIEWORI PLANS REVIEW I VEGETATIEV EWON I SEA REVIEW TURTLE VEWLE I MREV EWVE