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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO yMUS1T[B�E COMPI-' A FOI :PLICATION TO BE ACCEPTED - I (f, j'rypT Date: J r L 6 I Permit Number: b Z0Cn— n 1l." L �7 • SCANNED Building Permit Application BY Planning and Development Services St. Lucie County Building and Code -Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 - Phone: (772) 462-1553 Fax: (772) 46271578 Commercial_ Residential PERMIT APPLICATION FOR: \(�sI,� �,ysr2N431� Address: Foa(:) Ploan`Iot*,or,. lakes Dr f -•A Uillage asL 3Y�, Legal Description: Property Tax ID #:1 �3 - 0 0 3 a ©on Lot No. �i Site Plan Name: %jam 1 } 4-6 Block No. Project Name: K A3I1 M r6-1 ? '5fTR-:�,>i, 'J A'' r'--Tt-I-O`p-- Setbacks Front Back: Right Side: Left Side: Additional work to be pertormed under tnis permit- check all tnat apply: _Mechanical ✓Gas Tank ✓Gas Piping _Shutters "``Windows/Doors V Electric ✓ Plumbing _Sprinklers /Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ _ ISM Utilities: —Sewer _Septic Building Height: P a OWNER/LESSEE: CO 7`RACTO1. Name a v,1 c 'AS�MIS�'C._C(yO` Na e: 70 n Address.:g4a+�+�Fan}o•`I`i18t1-��ci< < C mpany:�KL �ilU.rv:inv�. City: - S+ls��vt>�Z� +,-u i4 State: Zip Code: %-4 9 f 6 Fax: Phone No. )'7 -^�i�i]`t -G9 s dress: /304 AJFP.L/iA S r ty: Ten s 2ti (3 e&f i, Stater Zl Code: 3 Lf S S% Fax: 7 Ph ne No I-7 E-Mail:_66' Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-M -1 J (5 k Yr �'C 3 e Yr.I,00 G oiw State or unty License I 3 ' If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. / U1,009MENI . • SUR ., ION L EN LAW INFORM N: DESIGNER/ENGINEER: Name: A -Al Duk Leo _ Not Applicable MORTGAGE COMPANY: of Applicable Name: Address:_I913 C,-rVo,, e5 Address: City: V a State: _ F! Zip: Phone 77a2 �IL95'--64y4/ City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Name: A-544,2i2r r Skhsdrt --Not Applicable t�€±�i�A BONDING COMPANY: _Not Applicable Name: Address:9&:Frt5';•J Address: City: o S♦ CL.� City: Zip: 244&G Phone: q 71T, Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby rrade•to'obtain a per riitto 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 Owner/ Lessee/Contractor as Agent for Owner Sig ature of Contractor/License Holder STATE OF FLORIDATATE Seq. Sege OF FLORID S Lt COUNTY( COUNTY OF c c The for oing instrum nt was acknowledge before me The forgoing instrument was acknowledged before me feI3r�Avg� this day of 20 by this 111 dayof 2011 by n (Name of person acknowledging) (Name of person acknowledging ) ( INC1n,W I.. Jd% (Signature of Notary blic-State of Florida) (Signature of Notary Public- State of Florida ) Personally Known OR Produced Identification Personally Known ✓/ Q_R P roduqedldentification Type of Identification Type of Identifica i +,,, BLANCA,C. SOSA Produced 1.-. 5' Produced II ogyIC . State of Florida (" - Commission i FF 962932 Ij.CommissionNo. 'Mg Comm.Eli�Mij29.2020 Commission No. tSol 'w, DEANNAMARIEGIV IB r�t;@IjJJSSIoNNGGu1 3 o`= EXPIRES: December 16, 2U:.0 mR• ° Bonded through Ntlfonal Notary Assn '%e•••••o-1 Bonded Tiw Notary PuNleUnden»iFe�s REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Nev.