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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONi All APPLICABLE INFO MUST BE COM',"-- . ED FOR APPLICATION TO BE ACCEPTED D e: Aj(. z Permit Number: SCANNED .. e �BY . aua n , StiLueppe. Cow* Building Permit Application QRAX3.J PI Inning and Development Services 3� 8 'Iding and Code Regulation Division 2 0 Virginia Avenue, Fort Pierce FL 34982 P one: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential i P WIT APPLICATION FOR: P� Ad �36 a . •Ott � �,� � NP �C1�U �' �� �: � CTI��i � ,,; press: c /�/P��� T I-e g-a- Leg I Description: �! YJvNO i Property Tax I D #: ocm Lot No. '11/6 SitE Plan Name: Block No. ProtIect nn �c Name: Oi-Clr RAC -Ale Se I i acks Front ze V Back: Right Side: S'D Left Side: b�� . 0 ply 2 i i . �sTRu -1"12 o, a T(cri 'a . Additional Total Co,�t work to e pertormed under this permit -check that app y- , /echanical _Gas Tank Gas Piping Shutters '1Nindo'ws/Doorsc'' Electric Iumbing —Sprinklers —Generator _Roof Pitch Sq. Ft of`Construction: y 'r Sq. Ft. of First Floor: of Construction: $f® Utilities: Sewer eptic Building Height: I Ed a A Name: i f "L CjLLI L�CrI Company: a� •.:. '1tt1JJ c .s�.,ti 'A'ddress: N A Ci LIP P � dress: � % 'tTeBG'.L; �z ✓e .. r '•,rJrr a y. r ..............I G/li�� R 1 . 1(1Fl•4 State:. Code: 3�/1�� Fax: done No. 77Z- City: State: Zip Code: .i 2_%/ Fax:77Z - -7 ail: E- Phone No%72- S377— y I� in fee simple Title Holder on next page ( if different m the Owner listed above) _9Z E-Mail is ' 'e_ 'v ile-de-rj Fi r State or County License r0900z ©Z Ifv ue of construction is 2500 or more, a RECORDED Notice of Commencement is required. t DESIGNER/ENGINEER: _ Not Applicable Name: Address: City: State: Zip: Phone FEE SIMPLE .TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: Phone: MORTGAGE COMPANY: Name: '- Address: City: Zip: Phone: Not Applicable State: 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, peeform 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 attornev before commencing worilkor recordin i Signatur of wner/ Lessee/ ur Notice of Commencement. as Agent for Owner STATE OF FLORIDA . COUNTY OF The forgoing insttclqrient was acknowledged before me this day of 20-M by CIS (Name o'Aperson acknowledging) (sighawfe oMotary Public- State of FloridA ) Personally Known OR Produced Identification Type of Identification r s ;uJ,6�c Produced LASHAHNAINGRAM Notary t'ublic -State of Florii Expires Dec 20, 2( Commission No. r' =., � 9o9111111Posion # FF 177249 %;f •• .r oy�palational Nolery Al REVIEWS I FRONT I ZONING COUNTER REVIEW DATE RECEIVED DATE COMPLETED Sign atureffContra ctor/License Holder ST . E OF FLORIDA 1 COUNTY OF The forgoing inst ument was ac thi� day oknowledged before me f 20_)Z by `i (Name o erson acknowledging ) (Signature of Notary Public-Stateb3Florida ) Personally Known OR Produced Identification _ pe of Identifica ; LASHAHNA INGRAM oduced ' 110tagy Putillu - State of Florida j •= MyComm. Expjj s.�D,��1c 20, 2018 mmission No. �5 ommlasior4.FA77249 �. , i� O'endtd through National Notary Assn. SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE REVIEW REVIEW REVIEW REVIEW REVIEW