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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: REDEI`� =D JAN 19 zi111 Building Permit Application SCANNED Planning and Development Services By St. Luce CozIntV 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: To Select from dropbox, click arrow at the end of line �� r C� III PRO PO5ED;IMPROVE MENTIOCATICI Address: 10WID J U11C(Lr'syY I-Lr Legal Description: t-I-t -hahi1n5^0✓1 14o4,1QI.. C(c-b eArd-t;Wt(ViWfyt Property Tax ID #: D000 000 - 9 Lot No. Site Plan Name: I SiCW1cL (2n-t� t-Jo Block No. � Project Name: I-Vf l V15r9x 15 la u,, C)C x�-w-t Setbacks Front !hO Back: — Right Side:_ Left Side: (' (a -P+ 07� 5+ 11i3h bO h +e. f/V G ae r' 0,ss CONSTCTI RUON=INF,ORMATIOW = rtiona wor to e e orme un El ert ispermit-c ec a appy: ❑_ HVAC Gas Tank Gas Piping _ Shutters Windows/Doors Electric 0 Plumbing Sprinklers Generator Roof Roof pitch Total Sq. Ft of Construction: Stt. Ft. of First Floor: ElSeptic Cost of Construction: $ .'� C)C Utilities: Sewer Building Height: , 01NIVER%[ ESEE _ ; >.. CONTRA CiOR . . u Name A-U4 &(yts j9 L<IrwNn1 0-IL, ) Cz Name: PK -. c Address: 1OLWO cS 06l3l-na),r Company: CSolw 1 U City: State:J:1, Zip Code: 3+q9(v Fax: Phone No. Address: 'P© 6opso acP3(o City: '54A+-a- +- State: FL- Zip Code: 30g S Fax: Phone No. E-Mail: hu+cFl jsIoJLLb(%1cLc)[.Cbivl Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail: Sr%e» cP C�Foel I SOd (tn , ��f State or County License: Li a"0OCV 0 a If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLENtRTAL'"CONSTRUCTION°LFEt LAW. IfVFORfVlA710iV DESIGNER/ENGINEER: Name: Not Applicable MORTGAGE COMPANY: Name: Not Applicable Address: Address: City: Zip: Phone: State: City: Zip: Phone: State: _ FEE SIMPLE TITLEHOLDER: _ Name: Not Applicable BONDING COMPANY: Name: _Not Applicable Address: Address: City: City: Zip: Phone: Zip: Phone: I certify that no work or installation has commenced prior to the issuance of a permit. St. Lucie Count yY 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 inspe Ion. If you intend to obtain financing, consult with lender or an attorney before commencing workAr recording your Notice of Commencement. / s Signature of Owner/Lessee/Contractor r-0wner Signature ntractor/License Holder..* STATE OF FLORIDA STATE OF FLORIDA i COUNTY OF IlAay`{'t Vh COUNTY OF dY10.1/ LVl The forg�gq,rng instrument was acknowledged before..me this IN'of, 201�by The forgoing instrument was acknowledged before me this j_ ay of O.JM+.ID.h.t.. 20 J—T by (Name of person acknowledgW of person acknowledgingDIANE K BO DYSION #FF7 5430EXPIRES(Signature of Notary Public-cla) FlorldaNalaryServlce.c mSig tur of Notary Public - State of Florida ) Personally Known L"" OR Produced Identification Personally Known L/ OR Produced Identification Type of Identification Produced Type of Identification Produced Commission No. (Seal) '., oti DIA ea Commission No. E K BOND i' MY COMMISSION # ''+"°'�"/ EXPIRES December 28, 201 a I II Revised 07/15/2014 (Utltj 3eeorBe Florltlallorarv9onlco cem REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER R VIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS