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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONV' ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ` a.S I `� Permit q Number: 1 (31 -OS 9 3 =22'= Building Permit Application RECEIVED Planning and Development Services Building and Code Regulation Division JAN 25 Z()19 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Resldentjtil' Cou,<Permitting PERMIT APPLICATION, FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT'LOCATION_ � u ,.- 1 0PAfsi it MM Address: 2 2 AIA- Legal Description: /US -'kYLA0Q PIW SOVZ ' f PQ 60 - 4 8&e- G Property Tax IDN: )44* - 7 - 0004 b00-3 Lot No. 3,pp Site Plan Name: Block No. 7`f Project Name: ,*au,4-V1,ST-A Setbacks Front Back: Right Side: 'o Left Side: T s 9,E3/9nq,-lAJ_ AjFZV 9&87)?vEYdoN —IS l BL tit 'j` 047U iYc.O oA-( / 2 CA� 4AiZ6-- CONSTRUCTION1NFORMATIONg 1 Addiflonal work to be erformed under this permit -c ec all apply: � EIHVAC Gas Tank ❑Gas Piping _ Shutters © Windows/Doors L`JElectric © Plumbing []Sprinklers ElGenerator © Roof �2 Roof pitch Total Sq. Ft of Construction: 00 S Ft. of First Floor: Cost of Construction: $ (pop, 00 C2 Utilities: Sewer Septic Building Height: -31 OWNER/LESSEE: CONTRACTOR: Name VC70—C771AA) 11D/VNIS`%YLAW0A2 LI.0 Name: 0,9*-Do Address:%iro0 u% rtA4',cw 97 Company: U6AGaO/3LAA.W0 ge lklJ! , City: A4,A- i l State: FL Zip Code: 33/4Fax: — Phone No. is - S-12 Address: Z13 :� GyotPao Mt55 4PT- BG City: -AAALLki.J041,�1 State:-L Zip Code: 33 00L/- Fax: Phone No. :z86 - S72 - rf 548 4 E-Mail: YO2 ,? •t%S'lovl A1OMM, Nord Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail: VOL2T�9� SCeYt lZ9,na�S CO ✓✓( State or County License: CAC 0 Z/ -72 8 If value of construction is $2500 or more, a jtECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: its DESIGNER/ENGINEER: _ Not Applicable -Name: ),4V t�S$CCYAZ"� MORTGAGE COMPANY: - of Applicable Name: - Address: -.ICJ 1 �.So6Z ( Address: City: VE2o State: Zip: 32r160 Phone 772-S69-S-S037 City: State: Zip: Phone: FEE SIMPLE TITLEHOLDER: of Applicable Name: BONDING COMPANY: of 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 commencine work or recordine vour Notice of Commencement. nG( wa, Cam(' l -` Si l\t re`of'O�wner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA,,--� STATE OF FLO COUNTY OF 1 � COUNTY OF The forgoing instru ent as ac owledged before me The forgoing instrumen was a knowledged before me this -M day of t l--r -� . 20�jby this � day of 20�by Name of pe D�aking statement Name of person making statement Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced MIMA OIAZ � "'•x MARIA DIAZ ItCC 0e (Signature of N a r t f;e � �e'G0055017 L14— My Deo 13. 2020 ""'1�r-" s°a MyComm.E:pgas pec13.2020 Commission No DonAel ft*M� otWryAssn. G CO ©S f 77 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TIJRTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17