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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL A Dat INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Permit Number: RECEIVED Building Permit Application OCT .®A 1018 Planning and Development Services�u� Building and Code Regulation Division ' Permltting Department r�ED St. Lucie County 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Y Y \� @gLue's CrKAINential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PR'QPOSED,`IIVIPROVEMENT1 't -TION Address:-j ,_ 3(­Q-00 (116U H166(t A Legal Description: 31 3 iA r (L4 ke 1 - Property Tax ID #: J M — f1( ] 10 Oo ' 0 Lot No. Site Plan Name: Block No. Project Name: Setbi I icks Front Back: Right Side: Left Side: DETAILED DDESCRIPTION QF WORK I6 rel- ro c)-F w ity) Mt-Yj I p-uu, piW 0() u�S ire 301 e F-( 14- 9 a,S �I-er -U)+ . 7 9M )(0 Dz CONSTRUCT ION kINFORIVhATLON d ,e Ailditiona workto e nertormed under this permit —check a ❑HVAC Gas Tank ❑Gas Piping apply: Shutters Windows/Doors 11 Electric ❑ Plumbing Sprinklers ❑ Generator Roof oof pitch Total ISq. Ft of Construction: S . Ft. of First Floor: Cost of Construction: $ �>J 0 Utilities. Sewer MSeptic Building Height: OWNER/LESSEE:. CONTRACTOR:' F Nam Address:) City: Zip Code: Phone E-Mail: Fill in from +rt4 ►IYVli 4A P f+N . Name: ©Slkl lVtV i MI a Company: ILAW 61110 r00-f i (G CD fMC bi1\w no Ut -e State: _3 q ( - Fax: No. qi 03- I V 3 -- 19 L4 7 Address: l Cl Q 3 \A,) VlvJ Q:2 (f U City: OW chu- - State: Zip Code: N C41 d^ Fax: Phone No. fee simple Title Holder on next page (if different the Owner listed above) E-Mail: Stat or County License: If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. 101,0812018 14:50 LUVIANO ROOFI ti r , TARj663 357 3566 P.0011001 PPLEMENTAL CONSTRUCTION LiEN LAW INFORMATION: • DESIGNER ENGINEER: _ Not Applicable MORTGAGE COMPANY; Not Applicable Name: Name: Address: Address: City; State'. City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: —Not Applicable Name Name: Address: Address: City: City. Zip: Phone: Zip:. Phone: OWNER/ CONTRACTOR AFFIDVIT: Application Is hereby made to obtain a permit to do the work and installation as Indicated. I certify. ertify that no work or installation has commenced prior to the Issuance of a permit. St Loci@ Counttyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure which Is In onflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such structure. Pease consult with your Home Owners Association and review your deed or 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. following building permit applications are exempt from undergoing a full concurren review: room additions, ssory Structures, swimming pools, fences, walls, signs, screen rooms accessoryus to another non-residentlal use ANING TO OWNER: Your failure to Record a Notice of Co a cement ma suit in your paying twice for Ir m nts to roperty, A Notice of Commenceme m st be reco a and posted on the jobsite oje�first jspect n. If you intend to obtain financing con u�t with le de or,p-at�rney before SIghefui'w6f Qwn�eske/Contractor as Agent for Owner sign tur otWontractor/License rower STATE OF FLORIDA STATE OF FLORIDA COUNTY OFCOUNTY OF The f�o� oIng Instrument was acknowledgeoefore me The TdiAf Ing instrume w acknowledge fore me this -�—, day o QCX6 0e %%- ____, 20,E by this arC_A� bw I -- -- .-Af) 13amO of persdh king statement N e or perso arcing szamnui nally Known �OR Produced Identification Personal) nown OR Produced 1 ntlfication of Identification Type of tifiRtion _.o.._... _W.2c3o[rlweg r; IYIARL INA QODINez ommisslo%--MARLWA MY COMmiSSION g{ 1p4236 Comm � MI86i0N d G31t EXPIRFA June 13. 2021 EXPIRES June 13, 2021 i i REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW UPEMES WRAIO0MTN . ' DESIGNER/ENGINEER: Name: Address: City: Zip: _ Not Applicable TG E COMPANY: Not Applicable ;OR ame: Addres City: State: Zip: I lPhone: I S t Phone I FEE Name: Address: City- Zip:1 SIMPLE TITLE HOLDER: _ No p licab BO DING Y: _Not Applicable N A ress: ity: Phone: ip: f Phone: R/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installati that no work or installation has commenced prior to the issuance of a permit. County makes no representation that is granting a permit will authorize the permit holder to build the in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may rest[ Please consult with your Home Owners Association and review your deed for any restrictions which) leration of the granting of this requested permit, I do hereby agree that I will, in all respects, p lance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. awing building permit applications are exempt from undergoing a full concurrency review: room y structures, swimming pools, fences, walls, signs, screen rooms and access uses to another ING TO OWNER: Your failure to Record a Notice of Commencement ay r uIt in y ,ements to your property. A Notice of Commencement must be r Ord and the first inspection. If you intend to obtain financing, consult with en a or a �ncin work or recordin our Notice of Commencement. indicated. iject structure or prohibit such apply. erfor the work a ditions, on -residential use ur paying twice for O St on the jobsite attorney before Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/L cens older STATE OF FLORIDA STATE OF FLORIDA . OF Y1 COUNTY OF COUNTY The forgoing instrument was acknowledged before me The forgoing instrum i knowledgeoefore me this day of , 20_ by this day of 20 l by Name of person making statement Name of person making statement Personally Known OR Produced Identification Personally Known ,/ OR Produced Identification Type of Identification Type of Identification Pro uced Produced (Signature of Notary Public- State of Florida) (Signa - r SI M RLINA Commission No. (Seal) Commis idn _ MY COMMISSION GGI( EXPIRES June 13, 2021 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW _REVIEW REVIEW REVIEW DATE RECEIVED (� DA IE CO PLETED Rev. 8'2/17