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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION0 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: q 1/1/6 Permit Number: ko ©Y'i 00 1 SCANNED BY Pr St. Lucie County RECEIVE® Building Permit Application,, 1 2016 APR' 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: 'PROPOSED,INPRQVEMENT LOCAT,ION:.a' Address: 022/(w Pgrboul- Cove Pr. Agr;og Legal Description: Property Tax I D #: Itia7i — 7el - 2L, yf i`G Lot No. Site Plan Name: Block No. Project Name: 1 000# tt,i Ai ode boat LL S 19 Setbacks Front Back: Right Side: Left Side: ro Ai : D.ETAILED DESCRIPTION QF W A WK, mvv, „ n CO NSTRUCTION`'I'NFORMATION:° € Aaartiona wor to ape orme un er this permit —c ec all that app y:lt ',!:'Mechanical ,_ Gas Tank _ Gas Piping i, =Sh ��tters _ Wirfdows/Doors NElectric _Plumbing _Sprinklers ';---�Geerator _Roof, Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ 700• Utilities: _ Sewer _ Septic Building Height: . OWNER/LESSEE:. ' :. rY . ,,CONTRACTOR<p Name eC i c ont actor T/ac i (ie:. /ia//� �1 Address: ' yr - CTi% ��' ``c Company: Je14 TL o v� o9AA Address: 61// G n d City:State: City: -YTieree State: rL Zip Code: 9Z{9 Fax: Phone No. ' " " Zip Code: - q9 2!9 Fax: o�� E-Mail: Phone No 170-.�74 Fill in fee simple Title Holder on next page ( if different E-Mail Q l l p heoe itp yoAaa . c-oj" I v � State or County License �G DOOa 7a� from the Owner listed above) If value of construction is 2500 or more, a RECORDED Notice of commencement is required. N F 't Name: Address:_ City: State: Zip: Phone FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: Phon MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: _Not Applicable Address: City: 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 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 commencine work or recordine vour Notice of Commencement. Signatu a Owner/ ssee/Agent Signature fC Ofitractorfin6ense Holder x;.r•.. ,. STATE OF FLORIDA STATE OF FLORIDA itR; COUNTY OF x COUNTY OF The forgoing instru ent was acknowledged bef r� r 9 The forgoing instru nt was acknowledged before �g o this � day of 26& b s yN m this � day of 42 %LG�i 20 � b by y m dgs :� W g j p $$ 5��9 C - aq:lli (Name of person acknowl dging) (Name of person acknowledging) 'a (Signature of N ry Public- State of FI rida ) (Signature o otary Public- St to ofplorida) Personally Known 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 SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.