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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE -ACCEPTED Date: ' 19 Permit Num (gua5�__k Building Permit Ap 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 I O--$-�--- - - JAN 15 2019 Permitting Department St. Lucie County, FL PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line III I PROPOSED IMPROVEMENT LOCATION: cne....__ III Address: 57 0 3 L{a BZ. r` Legal Description: SECT Oq 10wosmP ,31D S emtlu 46 E 8f. Lucie County Property Tax ID #: 3 40 q- 114 - 00 0 4 - OO O -2 Lot No. Site Plan Name:-rup.r-o I` G, u Es7r kvc,F- 1 Block No. Project Name: _1119IT-0 hU (;ST ft-W' 21-741 Setbacks Front Back:7 i• 77 Right Sider I Left Side:,A" • I DETAILED DESCRIPTION OF WORK: III ONE S TD eq & U %T (t l)66 Ce>5 a fi6imuQ1d,J LI)BC' zow LIB BATH , VI uvinlU 2o0M CONSTRUCTION INFORMATION: III Gas Tank uE-cnecxdu dppiy: Piping Shutters © Windows/Doors ©Electric Plumbing ��2 µ Sprinklers Generator Roof Roof pitch Total Sq. Ft of Construction: q30 *� Sq. Ft. of First Floor: 760 + I8o(ajT g ^ y Cost of Construction:$ 1�,�()� I12111�i.� Utilities: Sewer®Septic Building Height: /q OWNER/LESSEE: CONTRACTOR: Name B I Name: C f}r" TC'Gf1S L Address: M 000D1AM PQ Company: 7 %�C f3U1�1=25 L� City: � RXES1"LWAE- State: �l Zip Code:3ggS-6-- Fax: Phone No. -% �E�iO )- r71 laa— Address: ghbO ,SWAN) M41 1� �.4VC City: P69_7-iT Lun'e Zip Code: qb Fax: ,3, Phone No. (%7Z� Z(D State:%'& 72-- (o5-i0 E-Mail: Fill in fee simple Title Holder on next page (if different from the Owner listed above) Z 0. E-Mail: NnetJ e o) tJEi� COUTFf IU e-r State or County License: i .I qzI % If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER ENGINEER: _ Not Applicable Name: ( MORTGAGE COMPANY: _ Not Applicable Name: dill Address: E 0 — Address: City: 6 State: rL, Zip: Phone I _ City: State: Zip: Phone: FEE SIMPLE TITLEHOLDER: _ Not Applicable Name: BONDING COMPANY: _Not Applicable 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 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 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 commencing work or recording our Notice of Commencement. Signature of Ow r/ Lessee/Contractor as Agent for Owner Sigfiature of Cont ctor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF JT LQ CI-C COUNTY OF .ST LUCTe The forgoing Instrument was acknowledged before me „ -TRMQA NO!� The forgoing instrument was acknowledged before me �-7Fh7UH/ "O this Iayof �2017 by T; this X 20� by day o}}f/� �''A1tFy T2/ese `ORi nCm �iill+� TGIPtP Name�on statement moo . Name of person ryaking statement r Personally Known V OR Produced Identification Q making Personally Known OR Produced Identification Type of Identification ��" y;, _&/ Type Type of Identification Produced s o N 4 Produced gF gI. (Signatu a of Notary ublic- tate of Florida) o, (Sign lure of No a Publi State of Florida) # Commission No. 47737 (Seal) Commission No. 64 679396 (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVI W REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17 1 4 L