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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APO LICABLE INFO MUST BE COMPLETED FVK APPLICATION TO BE ACCEPTED Date:,� Permit Number: 'll r - ;iRECEIVED SCANNED By AIJG 21101@ Building PermitPermitting Department St. Lucie County Planni 7g and Development Services Buildi', ig and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phon 1. (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PER,!"' IT APPLICATION FOR: PROPOSED ,NP nVEM NT LiJC It�3 Addres �;: 0 i Legal D,' scription: Propert Tax ID #: a 3/a - 44 q- oeyz - ayo - � Lot No. Site Pla i Name: Block No. Project ame: Setbac II s Front,2 Back: (C% Right Side: Left Side:. Tota I Cost c al work to be pertormed under this.permit - cnecK all tnat apply: chanical _ Gas Tank —Gas Piping —Shutters _ Windows/Doors ctric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Ft of Construction: )nstruction: $ Sq. Ft. of First Floor: Utilities: _ Sewer . Septic Building Height: OWNI ER/41'1M� CONTRACTOR. Name111 Address: City: III Zip Code: Phon E-Mai . 1GL.. or,wbaoa L?A ej Name: .S41D6/'i0' -SAP O� qCJQ 5. 5'16A hi n 5 Rd Company: A'Wco State: R 3�q Lf -1 Fax: - �' No. `�'7 a - .37© - 635 Addresses: (0/6O� S' ` •1- City: Pnol re- State: le Zip Code: �il�Z Fax: Phone No '7-7.:;)--. �i%+!d42 41 !D 0 O : P�'L F3 A-L 'i 1 � AoL , Co Al ee simple Title Holder on next page (if different Owner listed above) Fill in! from E-Mail State or County License , I the If value lOf construction is 2500 or more, a RECORDED Notice of Commencement is required. ANUL AM - Ilk 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, 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 commencingwork or recordingour Notice of Commencement. ev. S { • P' �11/)ENTAL, Ca Sl'� t�t`IO fif !AW 1' �FflRMATI.QN: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: I. City: State: City: - State: I' Zip: Phone _ Zip: Phone: '�I FEE SIMPLE TITLE HOLDER: Not Applicable. BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: x Signature of Ow r/ Lessee/Co actor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instru ent was acknowledged before me The forgoing instrument was acknowledged before me this �•l day of 20� by this day of , 20_ by ,I (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 Identifica 'o Type of Identification Produced 1 HNR IAGRAM lPublic Produced Commission No. _• « ° •= Notary -State of Florida +Comm. E($�?� Dec 20, 2018 Commission No. (Seal) =rF opt°cam Commission �'6 FF-177249 �..�» ,_'-yam;.-�.'"D-.,C� • c . REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW' REVIEW REVIEW REVIEW REVIEW REVIEW DATE I RECEIVED DATE COMPLETED 1