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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLIC, BLE INFO MUST BE COMPLE mu FOR APPLICATION TO BE ACCEPTED Date: I •�• Permit Number: I SCANNED RECEIVED C' By .t on, �0(9p,mm AUG 0 7 2018 Building Permit Applicatio ^ ST. Lucie County, Permitting Building and 2300 Virg(' Phone: ( Code Regulation Division pia Avenue, Fort Pierce FL 34982 72) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMI APPLICATION FOR: Address: Legal Des( iption: Property ax ID #: ram ---' � ®� i'—' ��© "-4 Lot No. Site Plan ame: Block No. /q f� aI� i 2 A ,�� 1t . A ��- A Setbacks Front Back: Right Side: Left Side: Additionall work to be performed under this permit — check all that apply: _Mec anical _ Gas Tank . Gas Piping _ Shutters _ indows/Doors Ele ric _ Plumbing _ Sprinklers _ Generator _RoofItCh Total S t of Construction: S . Ft. of -First Floor: Cost of Construction: $ �,�, f�Utilities: —Sewer _Septic Building Height: Name Address:.' City: ZipCod Phone N E-Mail: Fill in fe from th Name: 2IU> 145fe&i ompan:y: - Stater . S7l-7— Address:. -• �� city: cit . ; _ State• Zip Codea'D" Phone No Tl `17--�-- '7�ti,���� 5 d simple Title Holder on next page ( if different.. Owner listed above) E-Mail State or County Licensee", If value of�onstruction is 2500 or more, a RECORDED Notice of Commencement is required DESIGNER/ENGINEER: _ Not Applicable Name:, Address: City: State: Zip: Phone` FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: Phone: MORTGAGE COMPANY: _ Not Applicable -Name: Address: City:. State) Zip: Phone: l! 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 ndicated. 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: Sig ntractor as Agent for Owner Signature f Contractor icense Ho er STATE OF FLORIDAA STATE OF FLORIDA COUNTY OF COUNTY OF C�.l The o oing instJ;ent was acknowledge before me this day of 20�. by The fo ing instru e_nt was acknowledge before mel this day of 20 by I ' I (Name of perso acknowledging (Name of person 4cknoVviedgin ) .I (signature of Notary Pu lic- State of Florida) (Signature of Notary Public- State of Florida ) Personally Known OR Produced Identification _� Personally Known OR Produced, Identification) Type of Identifi Produced L D � � Type of Identifiration Produced L KARE .NIELSEN Commission N . t����r,,_ KAREN S. Nl�OEN: - Commission No. ';=Statep���� ,. CornFFnn:ssiOn 207484c =o State of Florida -Notary Public # GG 11, Fii, °�M.y corn mission Expires =� Commission # GG 207484 ��1,3 Kly i01r�m� ion x J. i REVIEWS VISOR PLANS VEGETATION SEATURTLE MAN', RO COUNTER 'REVIEW REVIEW REVIEW REVIEW` REVIEW REVIEW DATE ! RECEIVED .. DATE O COMPLETED Rev. 7/2014