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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION..All Af.PLICABL INFO UST:BE COMPLETED FOR'APPLICATICIN'16BE ACCEPTE- Date: ® jUANNED PetmltNumber:N BY '3t. Lucie County �R6�I D Building Per Application OCT - 4 2016 Planning and Development Services Public Works Building and Code Regulation Division St. Lucie county, FL Zilesidential 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial f PERMIT APPLICATION FOR: k /VIOQIFIG4�lvaJ C4(r ltf{ IR5k4 Address: OM 14n!r, q 14 1-7. R 3Y9 Y 9 Legal Description: Property Tax ID #: IZ41O SCE coOCr(L-) Oho 0 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: D-eC, /ln.00A CA-4-rox­) J;-t c4i/- G.r Ft • Additional work to be-pertormed uncler ME "permit —check all that apply: _Mechanical _`G'as'Tdnk _Gas Piping _Shutter's. 1 �IWindpinis'/pggr _ Electric 1` , _ Plumbing • _ Sprinklers Generator _ Roof • _ � ;raion' iy ( G� � i � I i � '� ��// f f/l ?n Total Sq. Ft of Con ruction: �•! •x. Sq. Ft of First Fldor d j Cost of Construction: $ trd > Utilities;+' Sewers-��Septic Building Height: Name OU40 �Sc2i3 CD -G�a tNGl.,.s,o.3. Na'mA: y? (L/�t.6,_!' .lL, r% Address: B N• 110t2Y AO AA-7-m,:�r�c.�s� o • a y?_(F ed ✓e 4 &,.r. Ie/UL /� S Ha T vie �r City: ,�'' / . 3' l-e!� CR State: G�• Address: l 6 1 L Zip Code: L °I mix: City:,5eW21ryState: -PL .�. _.., ... - �` Zip Code: 33 S 7 © Fax: oPhone.Nor E-Mail)oria'l v raihii.+.A Phone No cPnnR ia e4;" - 7'yu4 ,.-.o'. p •r7C ', =. h Fil(:in fee,siirlple j fe Holder._on.next page (if different CAM ' G 1 Sl 79 a2 "frorn th'e'Owner listed�'above) � State or County LicenseC6- c.0 — 29'77Co If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. I DESIGNER/ENGINEER: Not Applicable _1 M6kTGAGE COMPANY: _ Not Applicable 3 Name: �•�IL MA-L6µ4W-�D�-A•C�t^'9 pe51 4E rName: Address: uS 1 S Address: State: City: So aio� State: City: Zip:zPhone /' VN_ 16L 3 Zip Phone: FEE SIMPLE TITLEHOLDER: —Not Applicable BONDING COMPANY: _Not Applicable Name: 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 permitwill aufhoriie 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 pppr,hibit 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 commencing work Or recoraing your rvuMn Ur Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FL RIDA STATE OF FLQR�D COUNTY OF� ICE\�alnCS COUNTY 0F7�1[i lT� The forgoing instrument was acknowledged before me The forgoing instrument was acknowl Z ggd bVAQ bY re me this day of �'YYIi�X .20Uby this day of Aim i r i ca Y N"scYlnii�a u w�dr►r� ) (Name doff person acknowledging) r (Name of person acknowledging) •Ali An Ail I 1 lA 1 W LIJi V `ti. l/ \MJ ---- (Signature of Notary ublic-State of Florida ) ( gnature of Notary Pu ic- State of F YP Personally Known OR ProRot9ty-Pu61' d3 w iyti nA IC49N own - - OR Produced Identification - :. Type of Identification ;y CommissProducedMy do q, Comm. ECommission (Seal) No. �� oyaJ -' --(Seal No. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REV DATE ; A1, V °6e� ; AMIRICA Y. NI JOLSONJ RECEIVED Notary Public - St DATE \;: My Comm. Expires , COMPLETED�' ev. 14