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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APP 'ICABLE INFO MUST BE COMPLE i w FOR APPLICATION TO BE ACCEPTED Date: ! ro Permit Number: scANNED BY �. �� 1►`'� `" St. Lucie COWIN RECEIVED m Building Permit Application 16 2018 Planning and Development Services euildinl g and Code Regulation Division ST. Lucie County, Pernllttir+g_ 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial. Residential i PERMIT APPLICATION FOR: � PROV PRQPOSEQ I Il11ENT LQ:CATMC)!� Q N w re„ ,., Addres JJ: G gel IVC,-ff le- s .6h1 � - I L'IVS e w � Pft C �S7 Legal DLcription:,r +tJes JslcNcL �ivg_� C D/JLIo-Se-d-7-i'o>v � �AW01f I Gam/ 11 Property Tax ID#: #;:Y­Qa- %5'0/-.G�� %- 400--D /6 Lot No. Site Plan' Name: / e ff/e S Block No. Project IName: Setbacks Front Back: Right Side: Left Side: Total Si Cost of I al work to be pertormecl under tnis permit- cnecK all that apply:_ chanical _ Gas'Tank _ Gas Piping _ Shutters _ Windows/Doors ctric _Plumbing _Sprinklers _Generator Roof ai Pitch Ft of Construction: Ori%D Sq. Ft. of First Floor: instruction: $ 4(:O 6?0 ©� Utilities: —Sewer _Septic Building Height: le OWNER/LESS ET ° a s a a* CONTRACTQR. N me�i G Name ,61ea e c- dtiA t 1 e i . N7j +,j Address: G fir/ 45G f f /e s f��ycL .. Company: ife � %�;ud o � �'%�v l►�c rCity:: `�ws�+.✓ ;le.4 0-ti State: LL Address:'),/ �Pa 8 5 E iX �'�_° %�,au U Ziptde'7�'� Fax: City:,/4 Stater Phone i iNo. 77.2 j - /8/ Zip tode.&Yq ��— Fax: E-Mail: Phone No I! Fill in fee simple Title Holder on next page ( if different E-Mail®,'i�,e�s��NdoaG�ax�/. cow -from �he Owner listed above) ill State or County License If value Of construction is 2500 or more, a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER: /Not Applicable Name: RYA' Address: City: State:.. Zip: Phone FEE SIMPLE TITLE HOLDER: ✓ Not Applicable Name: a/A Address: City: Zip: Phone: MORTGAGE COMPANY: ,.Pot Applicable Name: NA- l:l.: Address: City: State: Zip: Phone: 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 prohibitsuch structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. I 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 yotjr Notice of Commencement. Signa ure of Owner Less /Con racto as Agent for Owner Signature of Contractor/License Holder tl STATE OF FLORIDA �'�, Lu STATE OF FLORIDA `n Q- J1 COUNTY OF clic COUNTY OF �( ' The forging instrument was acknowledged before me � day /i- f' by The for oing instrument was acknowledged before me �'5*ay l.lS 20Ab by this of U.4 "5 20A this of 26::&AL&9/ /Z X44"ic'e� &ACQ WaftI Q (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida ) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Di6vuS Lic- Type of Id�P,ificati n c o Produced Yl���a �(Q n�` Produced se. •��,l�P— Commission No. " Rd ikW Commissiona'� 'ei Sear � . „„, K'RIST LIVEIRA Commission N FF-242316 ,No Siet90f0�� • • jrigOW201 My i lrlM160n Exp June 21, 20M9 C mmon REVIEWS FRONT R PLAN VEGETATION SEA TURTLE. MANGROVE COUNTER REVIEW REVIEW RE REVIEW REVIEW REVIEW DATE RECEIVED _ DATE /8(/-? Ito COMPLETED ev. 7/2014