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HomeMy WebLinkAboutBuilding Permit Applicationn ALL APPLICABLEI I Fl /STO MU BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: l 1 t� t Permit Number: JNTY" JNTY �+ a n r u n Building Permit Application Planning and Devepment Services Building and Code egulation Division / 2300 Virginia Aven e, Fort Pierce FL 34982 ✓/ Phone: (772) 462}1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPUJATION FOR: To Select from dropbox, click arrow at the end of line Address: L4 0'7 1 ti HiQ - if S 1 Legal Description: �I f (71 Si7iPtL.� f% �C�i tT� i C� T 1I) Property Tax iDIt: !cx Ll()R- 11 (aI()d 1 f- ©rl'7�l{. i Site Plan Name: Lot No. 1() Block No. Project Name: I Setbacks Front ; Back: Right Side: Left Side: i k :-,r•a. - .c*ri' �:sx' c �..,.,.:n _T.. g,�ct .� ",yr t,_....v-. .t,.. r c1 � ,,� .;�ro4... �Ft. ?n �:.y.. r�a,..•:�t� `�::.�.,,¢¢��'n',..:�t .,�� ai (�'FC �i.w� Alf; •rte'- ,i': # n 'h+.� "4" 'LY' :1.���*�.U���'; `�i����, '�i,•�`}i� �r %i.3:�•�'�:� r7'�:>i:�"�+"t,'i'c", .�'.if'8';,'"l'$3afAt re",Ai•w. .=:.'�'�+.'`:?: L Electric Total Sq. Ft of Cost of Consh Gas Tank Plumbing S-?C�q• by this permit —chCCK all apply: jj��'jjshutters ❑Windows/Doors ❑Gas'Piping ❑Sprinklers L_,I Generator Roof So. Ft. of First Floor: Utilities: 0 Sewer 0 Septic Building Height: Name Cc(r tA'1his Name:-QY9-p,�D _Du/)� _ Address: L40-1 --A G �nf -a t Company:, —� *4 C», 0 Ckr 1p v city:t ['tY -V {h 1 to S"C. State:I�L(-- Address: t ► I '1ci TH aT Zip Code: Fax: City: (L: tcSE IR `rhl�l✓ 0l", 4'L State:_C—�-- Phone No. 1, (l <-e-1 Zip Code: .3 3 i j I - Fax:.5-[r I. 1 5T- 2!U S- C/ E -Mail,. Phone No. i t I- Fill in fee simple Titlil Holder on next page ( if different E -Mail: from the Owner listeif above) State or County License: C.(n o C :3,a .7, i If value of construction`is $2500 or more, a RECORDED Notice of Commencement Is required. r _ 1 DESIGNER/ENGINFER: _Not Applicable Name: Address: City: State: _ Zip: 'hone: FEE SIMPLE TITLE OLDER: _ Not Applicable Name: Address: City: Zip: hone: MORTGAGE COMPANY: Not Applicable Name: W- 0 OVt��_ _ e. Address:' i, 1l \/) S/ "N'f City: C'_ra 91 4 reams State:/C— Zip:(at) 9-' Phone: 1�9U6. BONDING COMPANY: _Not Applicable Name: Address: City: Zip: Phone: I certify that no work x installation has commenced prior to the issuance of a permit St. Lucie County make; no representation that is granting a permit will authorize the permit holder to build the subject structure which is in conflict wit i any applicable Home Owners Association rules,:bylaws or and covenants that may restrict or prohibit such structure. Please cons ilt with your Home Owners Association and reviirw 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 th• ! 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, : wimming 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 • our 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 world or recording your Notice of Commencement. Signatu�,�,/e gena Lessee Sire of Contractor/License Holder I STATE OF FLORI STATE OF FLORI COUNTY I Cl(.�t� COUNTY OFA 1 w, i The for0. g instrumr ent was acknowledged before me The forgoing Instrument was acknowledged before me this - tay of O�ttMbtll . 20 t4 by this day of -_(, 0 V, 20 " by (Name0pArson ack iowledgfng) (Name of person acknowledging ) `. !.;�n!vy�e � ��� //lid% (Signatureof Notary;Public-State of,Flw®� YcF_ i� (Signature o aryYublic- State of Florida ) slO�'� � Personally Known OR Prodd.�cfa4tt<6yt ersonally Known t/ R Produced Identification Type of Identificatfar- Produced 1 - A tbeY 1 Type of Identificatio ! =* •'— os ANGELA YOUNG t Commission No. �2 �SeaI��12 �t oQ� Commission No. V COMMI&I11i EE18B635 EXPIRES April 12.2016 .i �2rrr It1101N\\\�1. Revised 07/15/2414 i REVIEWS F�ONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE CgUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE i COMPLETE INITIALS