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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE I JFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 7/ Permit Number: ^ 0 1 a 7 (P. E x_ mr RECEIVE® Building Permit Application Planning and Development Services DEC 17 2018 Building and Code Regulation Division Perm itti n a rtm e n 2300 Virginia Avenue, Fort Pierce FL 34982 9 e P Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Re idES4ia ntyr FL PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PRf7POSFD IMPROVFMENT LOCATION:'r Address: / ,?/ D Legal Description: z Property Tax ID q: 5 -Z-// 7 D / C/I Site Plan Name: e,4& /X/vQ/10 Project Name: 114 L / Ii/U i Setbacks Front Back:' 6 F1 Right Side: / 9 y Left Side: / 76 A/-ek) C'6S -f /5& 3 6bTk '/ Lot No. % %r!esro�u CONSTRUCTION INFORMATION: 70clitional work to be e orme under tispermit-check .ail . apply: ®HVAC 0GasTank ❑Gas Piping _Shutters LZ Windows/Door ©Electric Plumbing Sprinklers Generator Roof /Z Roof pitch Total Sq. Ft of Construction: .3 9 6 Z S Ft. of First Floor: 3 � 9 z— Cost of Construction: $�" "^ u Utilities:Sewer Septic Building Height: Van ah OWNER/LESSEE: CONTRACTOR: Name IVAZZ Name: .4. JD bf>DG'-% Address://9007E AYL/nLGk /.flit/ Company:1/7244 (pocOG�✓n/!1ft�!!/LL City: / t • 4ell % f7 Stater/ Zip Code: Fax: Phone No. 117z-60/g Address: 0 City: /: State:✓/ Zip Code: 3V,!rl Fax: Phone No. 416 5 1 E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail: �141/�'i !wJ vF f,19), [nhDi. _6/) State or County License: C /Z ) y If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. (::a \35 W SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGA(j E COMPANY: _ Not Applicable Name: ('� lglG , IIAIr/IJ,,p)� /!�. Name: (tgw7-F115r,47X &;:a/r Address: Address: i9�/ fS 5r'Nlt/ City: State: City: rNERi /Jv�N State: /�/ Zip: Phone Z 0 Zip: 3189/ 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 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 con lict 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 r suit in your paying twice for improvements to you property. A Notice of Commencement must be reco d and posted on the jobsite before the first ins ion. If you intend to obtain financing, consult with er or an attorney before commencingwor o reccoordin our Notice of Commencement. � f fin. 1 �ti•••• .. Signature of ner/ Lessee/Contractor as Agent for -i Signature of Contractor/License older m " STATE OF FLORIDA 3 �� a x� STATE OF FLORIDA f a COUNTY OF e, COUNTY OF ME The forgoing instru ent was acknowledged before m 6 v,us m The forgoing instru nt was acknowledged before m ({�,26�by ag this day of /C 20f�by g� thisdayof ��Ts N ' T 6WTS �� 6-0 �yC mm Name of person king statement "N Name of person ryaking statement ✓ Personally Known / OR Produced Identificatio a ersonally Known OR Produced Identification Type of Identification ype of Identification Produced Produced ((1����� ��n�jjjj//;;'�__ (Signature of Not ublic- State of Florida (Signature of Nota Public- State of Florida) Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.B/2/17