HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI
ALL AP INFO MUST BE tvmPLETED FOR APPLICATION TO BE ACCEPI
Date: /! fh� 0 v Permit d umber:
RECEIVED
—06
BuildingPermit Application SEC 10 211113
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 Residential
Phone: (772) 462-1553 Fax:(772)462-1578 Commercial
PERMIT APPLICATION FOR: Fuel
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Address: 1JJ00 Pirt d blyd f;(* ..'e,rLf F1. 3 SZ 1/2 4F ?��
Legal Description:
R�"4"Alt "Yi'a* Glub Eshkits -'J'd Z QIK
11 Hl I l.o%S 19 G of 7A :
SCA Lot No.
Property Tax ID H: 3�9 ^ �3 - Oo38 C) — B
Site Plan Name:
St I r rrie _Count9lock No,
Project Name: S3)AZer- &ener44to /R&a Pr°sera setbacks Front D Back: Right Side: 10 Left Side: ) O
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rtrona wor to e e orme un derrms permit—c ec . a app y:
�HVACGasTank ®Gas Piping n(_Shutters ❑Windows/Doors
Electric OPlumbing ❑Sprinklers GeneratoiRoof
Total Sq. Ft of Construction: S : L . FtFt.( of First Floor.
Cost of Construction: $ Z� I g • Z UtilitiesKl�Sye}wejr'r/ �pSeptic Building Height:
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OW�1Eit%LESSEE �_, x
La ..•Lot', (2iilJar - ,...... Name: nY Licashi
Name
: CompanyAmenas
Address- 17^U�rn FrrKic a) 61Jd 330t 0eanderAve
City: �Or� f r&rf Stater Address:
City: Fort Pierce State: FL
Zip Code: 3�t4gZ Fax: 34982, 772-465-8448
Phone No. 2' U1, - (e L54 Zip Code: Fax:
Phone No. 772"633-0740
E-Mail: @
Bdan.Pearl amen as.com
Fill in fee simple Title Holder on next page ( if different E-Mail: 02707/28679
from the owner listed above) State or County l tense:
If value of wnstruction is $2soo or more, a RECORDED Notice of commencement is required.
SUPPLEMENT/ALGONSTtUCTI(3N'UEN LAW trNFQ9
AT10N =, t e,a a. a
r
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY: _
Name:
Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER:
Name:
_ Not Applicable
BONDING COMPANY: _Not
Name:
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.
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.
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,
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
impr em t o y property. A Notice of Commenceme be r rded and posted on the jobsite
befo the f spec ' n. If you intend to obtain financin consult th len er or an attorney before
com 'nci or re)cording your Notice of Commence t.
Signat a of 0 net/ Lessee/Contractor as Agent for Owner
Signat re of C nt r/License Holder
STATE OF ORIDA
STATE O ORIDA
COUNTY OF 1S\r LA_j \Q
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
day �¢ort\Y14r 20—E by
this LL" day of 20A by
this of .
LGcr y '
I ��Cs— J r1
Name of person making statement
Name of person aking statement
Personally Known � OR Produced Identification
Personally Known � OR Produced Identification
Type of Identification
Type of Identification '�
S Notary Public State of Florid
Produced
Produced o.p0
- Angela .. rep
Commission GO 19060
',r Expires 02,2712022
pM1e.
(Signature of Notary Public•'Sta�gfFlO0�� public State of Florida
ignature of Notary Public -State of Florida )
. i '��' A'�n.g I M Boare
Commission N . \ O p M� Amlwion GG 19o909
mmission No..(7-- — C) (Seal)
ry ar Expires 02/2712022
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DATE
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DATE
COMPLETED
Rev.8/2/17