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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE IN O MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED. Date: 3 Permit Number: r~ . z r C RECEIVED Building Permit Application ion DEC o 3 2m Planning and Development Services ST. Lucie County, F-ermittinb Building and Code Regulation Division 2306 Virginia Avenue, Fort Pierce FL 34982 CANNED Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: P " K To Select from dro box, click arrow at the end of line F Address: SO Legal Description: - �- .13/5-113-oeoI-01o7 Lot No. Site Plan Name: Block No. Project Name: (n'n,9JNe1 ReSicleNTS Setbacks Front L 9S Back: - TO Right Side: �� Left Side: 292 -- '9141 C`i`Nf)Ct $,�N�/P -AIVI 7�oJk{ C©�✓NE� /�a.�i�iwJ /IUD/aye -CONSTRUCTION,INF,ORMATIONs�,- it i na wot-checkertima apply:rtr oe �e MHVAC GasTank [:]GasPi. _Shutters ff W'ndows/Doors Electric [A Plumbing [IS rinklers � Genefator. _ Roof S� Roof pitch Total Sq_ Ft of Construction: 1 Y ;I'd V Sci. Ft. of First Floor: /O 8 8 r d Cost of Construction: $B Ili y3� Utilities: _Sewer Septic Building Height: /� G -h - CONTRACTOR: Name/ a Rk.g a CeorlA/F/ Name: e9wiye, Address: 5'61 S' x'my s oN Q of Company: City: 61 /;?rrP State: Zip Code: Fax: Phone No. 772- 971 - 11901 / SC/ -&W- 75-/7 Address: Gty: State:_ Tip Code: FaK: Phone No. E-Mail: M gne.(vairjl9/ ei 1�aNCe • eVIVI Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail: State or County License: If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. UPPLEL,ENTALGONSTRUGTSIONiLIENrL V1/SINiFORMATIQ.Ny DESIGNER/ENGINEER: Name: 'Ill Sld t- _ Not Applicable o i MORTGAGE COMPAJF4N�Y: Name: A.& QTaekson/ /Not Appli able �Rt�W L Jac SoV Address: 700 2.2 S AC ad Address: 170aS L City: V cro lirgc Zip: 32 (q Phone 77.2- State: r .22C— ;7iR2 City: Pow S-F. Loae Zip: 3YT97 Phone: State: 77.2-4I6- /3SD FEE SIMPLE TITLEHOLDER: Name: _ Not Applicable BONDING COMPANY: Name: _Not Applicable 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. 1 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 in 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, accessary 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 comm I encing work or recording our Notice of Commencement. as Signat'I r of Owner/ Lessee/Contractor Agent for Owner Signature of Contractor/License Holde STATE OF 5-. ��Cr P STATE OF FLORIDA OUNTY OFORIDA 1� COUNTY OF The fo oing instrument Nwaq acknowledged before me -The forgoing instrumen as acknowledged before me thisdray o_fI 11vv 201Z by this _ day of 20_ by Name of person making state ent / Name o person making statement Personally Known, OR Produced Identification (/ Personally Knox�{{ OR Produced Identification Type of Identifi lion ( n Produced b W \ice os r Type of Identification Produced MARIA CORD Ro (Si o calory Public- State of Fl NOTARY PUB C(Signature of Notary Public- State of Florida ) STATE OF FL Comm issi 3��C_ Clmo*FF2337 IDA WommissionNo. (Seal) Expires wir, Dig REVIEWS FRONT ZONING SUPERVISOR PLANS - VEGETATION SEA TURTLE MANGROVE I COUNTER REVIE REVIEW REVIEW REVIEW REVIEW REVIEW DATE 1 RECEIVED DATE COMPLETED Rev. 8/2/1?