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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLI (ABLE INFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED i Date: Permit Number:,�Cj`'��dy�� r "' =j RECEIVED ` � SEP 24 �iJl�. - _ Building Permit Applica 'ion Plannin and DevelopmentServices ST. Lucie County, Permitting Buildingl1and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone:lj(772) 462-1553 Fax: (772) 462-1578 Commercial Residential I FPI—R�'!1TAPPLICATION FOR: 44,��s1g9r)i Addressil / �%/ /�D5'L1G , %�C�/ 76-Z • Legal Dgscription: z LET 7<9 Propertl Tax.ID #: 24 Z> Z d � % ��� 9 Lot No. Site Plan Name: Block No. Z Project iName: ` Setbac !s Front Back: Right Side: Left Side: R"6r #/"01 04 SA�� Ti9 Additipnal work to be pertormed under this permit — check all that apply: _ I echanical _ Gas Tank _ Gas Piping _ Shutters _ lectric _ Plumbing _ Sprinklers _ Generator Total I. Ft of Construction: �l i Cost oil Construction: $ /© Sq. Ft. of First Floor: Utilities: —Sewer —Septic Windows/Doors v' Roof 3/ Z Pitch Building Height: OWNER%LESSEE. CUNTR�4CT®R: Name A`i Name: /j Company: Add�"ess:, %/g Xa1yt City:ll z;4 State: FL Zip Fode:?� �y g 7—Fax: Phonjle No. Address: <y�LC City:State:��,,w �ii _L--2 Zip Code: 3 �t9g3 Fax: Phone No 7 _7Z 72 q 9// O E-M,' il: Fill in fee simple Title Holder on next page ( if different fro Il! the Owner listed above) E-Mail /6D- K-W S /-706-Z State or County License / Li / i? z s9737 If vald,b of construction is 2500 or more, a RECORDED Notice of Commencement is required. SUPPLEME WA CC? T10N NORM. INF�RiIATIaN. DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: Statek, Zip: Phone Zip: Phone: 1!� FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: I Address: Address: 'f City: City: I it Zip: Phone: Zip: Phone: OWNER/, -,CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as' �nclicatecl. 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. i In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work II in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.. I The following building permit applications are exempt from undergoing a full concurrency review: room additions, �I 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. Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contr ctor/License Holder STATE OF FLORIDA STATE OF FLOR_IPA COUNTY OF COUNTY OF - • 1-�lc`� e The forgoing instrument was acknowledge before me The forgoing instrument was acknowled&eg before me thisa� thisa+`� day of 20M by day of 2001X by b c A- d W% o rrih-A �► \fit � �- oyw. wA az (Name of person acknowledging) (Name of person acknowledging) i (Signature of Notary . blic- State of Florida) (Signature of Notary ublic- State of Florida ) i Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Idenpficcation t Produced Produced YY MARIE GIVENS �� p M Y COMM, SID'J # GG 022023 Commission No. - ' Commission No. IEGIVENSl� Sro # GG 022023 1Nr aj,#ar16,2020 ;a, EXPIRES ota Underwrite',• ryPutilic MYCOMMIS 16 ,. BondedThruN y1`� :0ecembet = ers Bonded'Mru N u REVIEWS ,rep` ` FRO •..::;,.� ' ERVISOR PLANS VEGETATION SEA TURTLE MANGROVE CO EVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED , DATE COMPLETED , Rev. 7/2014