HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLE' � .-, FOR APPLICATION TO BE ACCEPTED
Date: / a/- /,50 Permit Number:
"iall � SCANNED
MENOWSOM Building Permit Application ! By
Planning and Development 5ervices St. Lucie County
Building and Code Regulation Division )
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772) 462-1578 Commercial Residential I
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PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED'IMPROVEMENT LOCATION:'•• II
Address: `100
SIG6' 6A
V97
Coll y h
Legal Description:
21 -
3gi
2*6ZL c( Ff
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Property Tax ID #:
3 -2 "7 -
3 I H
00t - 60-010
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Lot No.
Site Plan Name:
eG A S
A hG
rJ(�'E2
Block No.
Project Name:
PCC, A S
A
CE.Qrc a.- r7-E LO
A t- A- �
Setbacks Front
Back:
Right Side: Left Side:
DETAILED DESCRIPTION,OF WORK:
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CONSTRUCT _ION INFORMATION
rtiona wor to e e orme under this permit- check a apply: l
E1HVAC Gas Tank ❑Gas Piping Shutters ❑Windows%Doors
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Electric El Plumbing ❑Sprinklers Generator Roof
Total Sq. Ft of Construction: 55 A F
Cost of Construction: L��
S Ft. of First Floor: _
Utilities: Sewer 0 Septic
Of
Building Height:
OWNER/LESSEE-
CONTRACTOR
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Name U6 Y _T-0 y J
Name: ('/�Fi 0-k S
A (_(t..( S
Address ��
Company: IN 1)�i=/dSOftJ
Mdoac \/l
nruST
City: 7711 n ,grE P, State: �l
Zip Code: 3,3 Fax: s(o (- A96 - Ga o (
Phone No. 5(01 - .39a - q ( On
Address: l � y R JA1 Rl ERTC� UJ is (Z R b
City: .l.-/t-//,E t°ftRK
Zip Code: 33-4/ 6 3
Phone No. ,SGi- 660L-
State:�l
Fax: 9779
/9'lq CR05t
E-Mail: ku). eoM
Fill in fee simple Title Holder on next page ( if different
from the owner listed above)
E-Mail: AA l
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State or County License.
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If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUL�= PPLEMENTALtONSTRUCTIQ.-_LAWINFORMATION:-°
: .,
{s ..
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address:
Address:
t
City: State:
Zip: Phone:
City:
Zip: Phone:
i State:
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FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY:
Name:
—Not Applicable
Address:
Address:
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City:
City:
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Zip: Phone:
Zip: Phone:
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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 thesubject 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 -re #dential 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 vour Notice of Commencement. i I
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STATE OF FLOr�pA STATE OF Fl.
COUNTY OF d ALM ?JeAC1'A I COUNTY OF
The for oing instrumentwk owledged before me
this�tlayof20 14 by
Con c I 5 X-.
re
H
The forggoing instrument was acknowledged beft
this /y day of 5AN 20__g by
(Name of
of
Personally Known OR Produced Identification Personally Known _
Type of Identification Produced Type of Identification
Commission No.
NM 0TTAYM
Revised 07/15/2014
Commission No.
of
me
13,2016
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