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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE CON.,_ -TED FOR APPLICATION TO BE ACCEPTEI Date: 113 1 5 Permit Number: /J-(� Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 SCANNED BY St. Lucie County RECEIVED Building Permit Application APR 13 2015 Commercial PERMIT APPLICATION FOR: E L EGTi2 (C Address: Legal Description: Property Tax ID #: ! lot 3 —0000-q.019 </(cd Site Plan Name: 51- C, M o Sca Lni t9 Co., 7iw / /(o A/ Project Name: Setbacks Front Back: Right Side: Left Side: Residential s a , ✓f,2e/ r _ye Ln�P Lageia l " �, RePI¢te PXichK 3 `Pale 9,cf4 /3r t�ca it l-0r Lot No. Block No. -'? /,.� oJ- GLN�ra Ce �, lK, pr, P siw-7 and �CG // '9%i ' Yd U 9 GONSTRUCTI©N INFORMATION: rtiona wor to a pe orme un ert is permit-c ec a tat apply: 1=Mechanical _ Gas Tank _ Gas Piping Shutters _ Windows/Doors ;` 2�Electr',ic _ Plumbing rJ••. _ Sprinklers Generator _ Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ 000r00 Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name SLC Name: &'r-A-4 k fedyic: Snc. Address: Company: oA%5-2lpr W. /lri�' , a �• f City: State:_ Zip Code: Fax: Phone No. Address: 3086 Eh IoZ 69�e City: f%. PI r c e Zip Code: .3/Y92 8 Phone No (7?2) State: r 1 Fax: C�?2) 1'6(- (9cj'7 V6/-195'I E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail CA ,•s (P n z ale torc64e 1 n c • e M State or County License E G o O o 7 9 G 3 If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CO,xilNSTRUC I u=mom�N LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: 7--; State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE-HOLOER: _ Not Apprica—b-fe 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 accessoryuses 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 your Notice of Commencement. tN Signature of Owner/ Lessee/Agent "?_•, ignature of Contractor/License Holder •v STATE OF FLORIDA TATE OF FLORID —•' N ;," COUNTY OF F"� R` OUNTY C ' instr enty{n as a� cknowledged before m The fo Ma 8 ego m The for oing instr nt was acknowledged before ' g" ME9 this�dayof h_ 20� byN this /dayof 20�by �;NNw )- gc QR %ST - �.i YbrT= �. mT (Name of person acknowledging) 1 (Name of person acknowledging) (Signature f otary Public -State of TloriclEy ( nature of Vfary Public-S too IoridarV Personally Known J OR Produced Identification Personally Known -' OR Produced Identification Type of Identification Type of Identification Produced Produced Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Hev.//ZU14