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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAIL APPLICABLE INFOMUST BE C01=,_'J_TED FOR APPLICATION TO BE ACCEPTS. // Date: ( -0. / y • Permit Number: SCANNED BY St. Lucie County Building Permit Application RECEIVED Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: Address: r71/d0 5. (,(h Legal Description: �rMLUJ L, JUN -5 4;3 Property Tax ID #: 3yb2,-,R01 - 0m63 - 000 Lot No. 2-3- Site Plan Name: Block No. Project Name: 71/{ Setbacks Front Back: Right Side: Left Side: /nn i-lL l/ii�n/ � ili in.��rir.'f ter... .el .n i,n .:ram' r5 '(�ni��%t�✓ S/N,_0 AaamonaiworxtoDeperrormeu unaeruusperrna-aiec _Mechanical' _ Gas Tank _ Gas Piping _ Electric' E V Plumbing _ Sprinklers Total Sq.'Ft'ofConstruction: ZJRo r Cost of Construction: $ a*Y _ Shutters _iGenerator Sq. Ft.`ofFirst Floor: _ Windows/Doors Roof Utilities: _Sewer _Septic Building Height: 0WN @E—SSEE: C©NTRACTOR: Name �yoly 5 A Name: 4Ar-er' t vti Addres : 2-0900 U SUB 8 Company: LfVA P MVnW Nfr City: > 11p f4 State:A Zip Code: ?% �O Fax: Phone No. r{0-) -(A' y' 307(D Address: /Soa Sol 41etlti6d Avg. City: P5 i, State: 25 zip Code: Fax: 77a-�7a 3�73 Phone No 7Q1c 5Y6 &9.2-f E-Mail: 41'A6W.00 Y066, Boryl Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail AL 1147 vlsfp ya hod. 60m State or County License 6'`G lw&5 6L'& If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFO NATION: DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: _ City:_' Stat Zip:" Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not AppI' able Name: BONDING COMPANY: _Not Applicable Name: Address: Address: City: City: Zip: Phone: Zip: ne: 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 Commenceme t may result in your paying twice for improvements t o r property. A Notice of Commencement must e r corded and posted on the jobsite before the first' sp ction. If you intend to obtain financing, cons t wit lender or an attorney before commencing w rk r recording your Notice of Commencement. SiggKFT 0 ne c/ Le -ee/Agent Si n e of ntr 8ctor/License Holder STATE OF FLORI �R STATE OF FLORID — �� COUNTY OF s �� = COUNTY OF n Pa"iU ¢ LL� �2 The fgrgoing inst�u ent was acknowledged�efor this Z day of 20 by¢ i' 2 The fgcgoing instre ent was acknowledged this day of 20Z1w tt@ 2 o�¢E E w a V /� 1V' A— S (Name of person acknowl dging) ;: •" " .y (Name of person acknowledging) '?•• 'M .`n9r I� ry1 (ignature of tary Public- State of Florida ) (Signature oftNotary Public- State of Florida I / Personally Known . OR Produced Identification Personally Known OR Produced Identification Type of Identificati n r Type of Identificati Produced • �.Al 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 ncv. i/c�1�