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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE.INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 \_. Date: zv - /- / -p Permit Nu 0O RE C..,UVED • Building Permit Application OCT 01 2018 Planning and Development Services Building and Code Regulation Division Permitting Department 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Rend Iaje 9LU nty, FL PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line 1-Mf PROPOSED IMPROVEMENT LOCATION: Address: E005 S 'L'V, O R • Le��gal Description: J 0 YtA � Q - S/ � 5 (Co r- T• or. IaTf iA 'T4j E4 r, " L ccs w4 rl t u (o.k 5Gz -+is L) 2CANNID rroperty Tax lD #: 34.01 - Co L O C)o i. - O o u by Lot No. 1 Ufa OMM No. Site Plan Name: ProjectName: CSSf1`3•" Setbacks Front Back: Right Side: Left Side: DETAILEDDESCRIPTION OF WORK: Q.u" ve, Q�f; �1ri ot-+.: A. Vd 0 �;, ��r lu,. a•: in�.� mew ��c/►� � (ioo�rlM�h ��+�J.. � 2.•�'1 a-` �%4 9hA�+�,il4�� '.�.An., 7M,�a N7V'l� � pV�✓' CONSTRUCTION INFORMATION: itiona wor to a er orme under this permit - c ec a ?p v: [1HVAC [] Gas Tank ❑Gas Piping Shutters Q Windows/Doors Electric ElPlumbing F]Sprinklers ? ,� - J Generator © Roof Roof pitch I Total Sq. Ft of Construction: 2 9 oU .-t. of First Floor: Cost of Construction: $ UtV :iF <.. Sewer Septic Building Height: OWNER/LESSEE: , ,CONTRACTOR: Name Zolux✓V J. (zrs.otr,. ;, Name: F�Cfyo(.cr L4val+, Company: IEL:1t. 4YAL41 S � Address: ( t V11000 4 - City: State: Address: T\l �ZipCode: k k%i Fax: Citv: SW01,1" State: VL Phone No. Zip Code: W5154 Fax: IE-Mail: Phone No. }YZ'613 - 7:)443 Fill in fee simple Title Holder on next page ( if different E-Mail: oF�;ta • a�>>t.wot^►+�+�'wv� �^°� �' �'�"'` State or County License: C C 033 0 3 31', ( rom the Owner listed above) If 1 value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: jDESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: State: Zip: Phone: City: State: Zip: Phone (FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: Not Applicable Name: Address: Address: City: Zip: Phone: City: Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. III 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 i i 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 vour Notice of Commencement. 1-7 Z7 Z_-400� - 'gna Owner/ Lessee/Contractor as Agent for Owner Si ure Contractor/License Holder l i STATE OF FLORIDA / STATE OF FLORIDA COUNTY OF COUNTY OF The for oing instru n w s acknowledged before me this day of 201� by The forggoing instru nt as acknowledged before me this ( day of d 0-r 20 /# Name of person making statement Personally Known _e OR Produced Identification Name of person making statement Personally Know OR Produced Identification Type of Identification Produced Type of Identifi ation Produced I (Signature of Nota�,y PublicFg�f�FiBaJano (Signature of No�t,r�ubliphg§ AfnG1ortdno ^ygSs+Op NOTARY PUBLIC Commission Now R OF FL&MA GG126275 eo sow NOTARY PUBLIC Commission y F FLOARI) Comm# GG126275 Comm# 021 s�N 9�e REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED