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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED D1 0 3 Permit Number SEP 00 2018 Building Permit Application ST. Lucie County, Permitting Pla' ning and Development Services Bui ling and Code Regulation Division 23 0 Virginia Avenue, Fort Pierce FL 34982 Ph IIne: (772) 462-1553 Fax: (772) 462-1578 Commercial SCANNED Residential M.,, R •� � . �-!t� ��u®Q9Vi1�a s PE I�MIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PR�POSEDIIVIPROVEIVIENT LOCATION � Add ° ss: Coo % C F4 3!�z 9 tea? Legal, Description: 02 .36 1/0 bl QCL5_` FLQ-E /t/ I g,Sfr Oe-i4l .37 r3 FE & Al Property Tax ID #:_3410 4 S// 1 �- 0901 - © o _j Lot No. Site Ian Name: Block No. Proj ict Name: Set ticks Front Back: Right Side:_ Left Side: DETAILED DESCRIPTION OF WORK I$ �gby.12 open cgrpor+ on �rouncl, nto plumbing, no eIeofrfc. (Z4 SIM C0: STRUCTION IN°FQRMATION ;. bona work to be nertormed under this permit -check a apply: HVAC Gas Tank []Gas Piping _ Shutters Q Windows/Doors 0 Electric 0 Plumbing Sprinklers E Generator 1:1 Roof Roof pitch Total Sq. Ft of Construction: 9 2b S . Ft. of First Floor: 17Z 0 Cost f Construction: $ �, O'I "1 Utilities: Sewer LJ Septic Building Height: Z 'I .O, { NgR%LESSEE CONTRACTO.Rt y:.. Name, Add City:ll Zip -54e-v¢. 4Y A a-e-hee Name: -Tame$ Ptq e r Company: Cyr "$ e ss: 60op ( C;• � u� y • ,' Stater ode0y9c o7 Fax: Address: h• Y. 71 City: 6'aaye State: rL Phone E-M Fill i No. 212, 5-19 -/'}OX il:.5 k&j- `ems- '0 a (;-Inn-a eeVA,2 Zip Code: 3Z0VII it Fax: Phone No. 06X- thp1B -'/11(0 E-Mail: ib aermi-t6 ft &gmai ,Cc M fee simple Title Holder on next page ( if different fro the Owner listed above) State or County License: C13C ) 2Si �lgrJ If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. CONST..RUCTION" Llf N LAW INFORMATION yPyPLEMENTAL DE IGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Nail i e. l _ Name: ress: r•Y Ad Address: Cit State: City: State: Zip' Q Phone oe Zip: Phone: FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: -,,.Aot Applicable Na _ e: Name: ress: Ad' Address: Cit City: Phone: Zip: Phone: Zip' OW ER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. I cer Jfy that no work or installation has commenced prior to the issuance of a permit. St. L Je County makes no representation that is granting a permit will authorize the permit holder to build the subject structure whic 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 co sideration 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 f llowing building permit applications are exempt from undergoing a full concurrency review: room additions, acce ory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use WAI NING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for imp, vements to your property. A Notice of Commencement must be recorded and posted on the jobsite bef a the first inspection. If you intend to obtain financing, consult with lender or an attorney before com linencing work or recording vour Notice of Commencement. fir' 1 ntractor as Agent for Owner Signature of Contractor/License Holder ST 4TE OF FLORIDA &1414 STATE OF FLORIDA COi� NTYOF l�. COUNTY OF 6rqd•�oYC� The forgoing instru gent was acknowledge before me this) day of 20/& by Name of pers9p making statement P�erally Known ✓ OR Produced Identification Tof Identification Public- State of Florida ) ( M�$$EY FRENCH Notary Public — State of Florida • _ Commission # GG 167258 My Comm. Expires. Dec11, 2021 EWS IFRONT I ZONING COUNTER REVIEW DA IE RE ^EIVED DA E CO PLETED Rev. 8/2/17 The forgoing instrument was acknowledged before me this 27. day of 20 ft by Ili Ames Pllu4e r Name of perso making statement Personally Known OR Produced Identification Type of Identification Produced A �,, -,., - Tx'�-� (D - (Sign ure ory f Notaublic- Sta--te--oTTIorida ) �N1YPie SIERRATERRELL (Seal) Commis* � '; , Expiros October 18, 2020 Atofa-' 8&*dWwedaodN9e.2—*— SUPERVISOR PLANS I VEGETATION I SEA TURTLE I MANGROVE REVIEW I REVIEW REVIEW REVIEW REVIEW