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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONn ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: � � • • Permit Number: �a I • Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Re RECEIVED NOV 0 8 2018 ST, Locle Count Permitting sidential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line I PROPOSED I M'P,ROVEMENT, LOCATION..,_,._.w. Address: ,2_L�gO ( oa_ CQJc 1�2 o ��Gi1 � ��- Address': Legal Description: COaAL, COJC eC44 '3Q:Z-- St I I:laie C fjnty i Property Tax ID #: �-Zs ' C`7 (- ©06Cp - Zq.d ,S Lot No. Site Plan Name: Cam' COW, &44 11� PLC, /1 Block No. ProjectllName: P A� 00 U I" 1 J pIci - Setbacks Front Back: Right Side: Left Side: DETAILED DESCR10TkON' OF WORK: CZ e ,�.� �s•-� z rJCr— i l t. C �oo� uJ ►_ Tl ,2 '4'"L . CONSTRUCTION INFORMATION: ditio'nal work to be nerformed under this permit - check all fn apply: ❑Hi AC Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors ❑i Electric ❑ Plumbing ❑Sprinklers ❑ Generator U40of Ff_ Roof pitch Total Sq. Ft of Construction: I q00 1;Q K S . Ft. of First Floor: 1100• i Cost of Construction: $ 1y c7 J Utilities: Sewer []Septic Building Height: OWNER/LESSEES •, CONTRACTOR: Name Name: vc Address 1: 4 Company: eD-1 13g, t31 J _ City: State._ Address: L(= rJ. �Otx IC City: (��t (,Pvtj A<_ State: � L Zip CodleI: Fax Phone No. 5 ��•!'- ® 3 Zip Code: 3313 (f Fax: S �ak o� E-Mail: - i�ii(�% Phone No. � S $ 6 Fill in fee simple Title Holder on next page ( if Afferent E-Mail: y'+ from the Owner listed above) ,I State or County License: C CC 0!�_'15'74 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. i. SURPLEMENTALCONSTRUCTION LIEN LAW, INFORMATION: DESIGNER/ENGINEER: _ Not Applicable Name: Address: MORTGAGE COMPANY: _ Not Applicable Name: Address: City:1 State: City: State: Zip: I Phone i Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address, Address: City: City: Zip: Phone: Zip: I Phone: I R/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated. 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 subject structure in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such a. Please consult with your Home Owners Association and review your deed for any restrictions which may apply. feration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work Dance with the approved plans, the Florida Building Codes and St. Lucie County Amendments. )wing building permit applications are exempt from undergoing a full concurrency review: room additions, y structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use ING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for ,ements to your property. A Notice of Commencement must be recorded and posted on the jobsite the first inspection. If you intend to obtain financing, consult with lender or an attorney before ?ncing work or recording vour Notice of Commencement. f ;Signature'of er/ Lessee/Contractor as Agent for Owner Signature of Contraor/License Holder ct STATE OF FL RIDA STATE OF FLORIDA COUNTY OF &LL_� COUNTY OF 62� The forgoing instrument was acknowledged before me The forgoing. instrument was acknowledged before me this 2�,, day of C4—C2CA , 20j�' by this day of 0Ct-o8cP_ 20 f�i by a I Name of person making statement Name of person making statement (Per ly Known OR Produced Identification erso Ily Known OR Produced Identification Type of Identification Type of Identification Produced Produced ""v'""'• DEBORAH EDITH REED eWlk:; Notary Public —State of Florida Commission # GG 113779 �( Q My Comm. Expires Jun 1 � '•'�;�oF�°;� �„v,� J Notary Assn Bonded through National NotaryAssn. (Signature of Notary Public- State of Florida(Signature of Notary Pub c- e o on a " 'CATH r.piB,, ERINESKELHORN Commission No. =_° `F: MYCOMMISSICI SeaW6455 Commission No. (Seal) EXPIRES: April 25, 2020 ";oF•��d BondedThru Notary Public Underwriters REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE' COMPLETED tev. 8/2/17