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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION- All APPLICABLE INFO MUST BE COMP,2�'eD FOR APPLICATION TO BE ACCEPTED ' Date: —.Z, 490 16 ,j1.ANNEp Permit Number: I (P �' 0 0 St. Luce county RECEIVED Building Permit Application WV /2 2016 Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce Ft 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: Address: Legal De A (' t A4 t4 t — PropgrtylTaxlDt# 't14 25 - 701 -O t6-7 , / $O-3 Lot No. Site Plan Name: Block No Project Name: >,A-) r VU [ Z Setbacks Front Back: Right Side: Left Side: Ari-Q IR% (= w S T VZ-4c a _Mechanical _ Gas Tank _ Electric _ Plumbing Total Sq. Ft of Construction: Cost of Construction: $ 00b , DO perms-uleL _ Gas Piping a _ Shutters _Sprinklers _Generator Sq. Ft. of First Floor: _ Utilities: _Sewer _Septic Windows/Doors Roof 1 Building Height: ®W N ER/LESSEE: C®NTRAC*�T®R: Na e FJN1C L'YQ'&tb-rzt_l_ Name 61XV1'0 fviSl�/LsllaLl I Address" tJcJ '7trNi CT CotripanylDhV��°1Q �1/�25i4t:tCi 6.c. ��'� Cro� ...� py .emu .�. ,,�,1;,.1 City: 13L.rA TnF_iAr�-=- = - - ---State: Fcr� Zip Code: 33317 Fax:954 54M-695( Phone No. 9 54- Sq 1 b g 5 I Address:-/-4`/ - .. � :.: 6-'-!4Aur&� ut!;LPL City: ORVJLi Zip Code: 33 3 z. Fax: Phone No 415ti- G orb - .39V I State:iL E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail J 6, 1 1 a ATT-. N State or County License C & C Sri 7 1 '6 If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. t 1 , OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a`perm'it 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 grantin&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, screeri 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•lende'r or an attorney before commencin work or recordingour Notice of Commencement. Signature of Own r/ Lessee/Contractor as gent for Owner �Signat of Contractor/License Holder - STATE OF FLORIDA 11 STATE' S PPLEMIENTAL C©NSTRU.C�TION LIEN LAW INF®'RMATION: DESIGNER/ENGINEER: _Not Applicable � Name:.li�M�S F. AI,'1'l., %'• L• MORTGAGE COMPANY: Name: Not Applicable Address:_S,� ,i i� P2�.SAu•� R�,?+� Address: City: O LANA n kY� State: r=� Zip: �33 oti Phone s7-7��•• 9afS City: Zip: Phone: State: FEE SIMPLE TITLE HOLDER: Not Applicable Name: BONDING COMPANY: Name: _Not Applicable Address: Address: City: City: Zip: Phone: Zip: Phone: _ OF FLORIQA, 11 ` ` r COUNTY OF wcsWA,(d� COUNTY OF , tbLO��` The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this � day of niOVCwtiYG✓ , 20� by this � day of /VoVr�ls-e� , 20.� by �t�� f'Yl✓#Y$�.�e,�l 1�J-t� YT1,nvs�-�.�1 (Name of pe on acknowledging) (Name of person acknowledging ) (Signature of tart' Public- State of Florida) (Signatur f Notary Public- tate of Florida ) Personally Known � OR Produced Identification Personally Known _� OR Produced Identification Type of Identificatio ' Type of Identification Produced {EVERLYDIANEMARS HALL Produced •'�!'ti"•" RLYDIgNE MARSfigLL MY COMMISSIQ N 1F EE863441 Commission No. X .. � EXpIRE��ihary08 MY C�IIg,S,c'ON * EE86�21 Commission No. `• •'• EX 20t7 1-�071398-0157 FbnOeNOWf$�ryp,py� ESJanu N07133i-0/51 F ari'oe•zo1% I�nlaNyy7&(YtB. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ' ev.