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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: a� �i Permit Number: 11 (X 6C RECEIVED JUN M 91017 SCANNED o ! B•. - - — --- - Building Permit Application St. Lucie county 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 RERMIT APPLICATION FOR: r`OM)ww.x�' st PR®POSED INPROUEMENT L©CATION: Address: o-ucLJ9ooI �o r(C T�con�lZr Q, �s�5'4v,ig Rg-rb4{a1 Legal Description: �� IL. ✓nod 1� ^Jk `^ �^ 4 - (31 3 FP 3/ q,5-/ -01% +` PropertyTaxlD##: lZO1 L.ol— 40-30— 07-0-7 Lot No. Site Plan Name: 7/ o S DcivL Block No. r'J Project Name: 5l4h 5 Setbacks Front Back: Right Side: Left Side: DETAILED DESCR PTION OF .ORK: CONSTRUCTION INFORMATIO Additional work to bepe orme un ert is permn:­Eheck all tatappy: _Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ 1 Qa O9 o Utilities: _ Sewer _ Septic Building Height: ' OWNER/LESSE : CONTRA IlnNemai;Ayf'v,ltiooAtlf Name 'Ir��,.r�- Lav-51� G� � :C�•'���o�S �.¢/IP,QoPc/L% /�OW,�PRS SSDC ress 7�d8 �e:,di/ kJ /(/� I Company : e I li a - • l3« ' ; .Add State_ `Address al 7'O G o�cr^ I ^vim R% City: State: E� Zip Code: 3iT4SFt-' wYFax'.7'9a-qt-V-*30/ Phone No.7.79 -Z{('f - 9377 Zip Code: '4g -q `1 5 Fax: E-Mail: Phone No (772 Fill in fee simple Title Holder on next page (if different E-Mail �-r LJ(- c aw s} n ; • `7 �� State or County License C-15 :�-) L4g L-f from the Owner listed above) i.; , If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. \1 SUPPLEMENTAL CONSTRUCTION Lif-N LAW PNFORMATI©N: DESIGNER/ENGINEER: _ Not Applicable Name: MORTGAGE COMPANY: _ Not Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: _Not Applicable 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 permit will authorize the permit holder to build the subject structure which is in contlict 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 commencin work or recordin our Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent for Owner SignaturW6f Contractor/License Holder STATE OF FLORIDA ST• STATE OF FLORIDA � "L COUNTY OF LVC IE I COUNTY OF 6 . w, K The forgoing instrument was acknowledged before me The for oing instrument, as acknowledged before me this day of APR - I I_ 2011 by this y40dayof CII 201-7 by L02(t A%NF INS'f C1L^ 116 ^ ��rsso�n�acckknnowledging (Name off person acknowledging) (Name o) ignatur o ota Public—Staf a of Florida) (Signature of Notary Public- State of Florida ) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Ide ification criRlsTOPRER . F)iR&tfl dentification ��� Produced 1VE2 (r1cEn�SE �: NOTARY PUB I�roduce d. Commission No. rr F142y14 o _STATE OF FL F3.1_DmmissionNo. 1dS71 •','�°'��LEEo SFF UE HA }¢ C'�m�' �tq s�kcEt's�° Expires7117 ._ - My Commission Ezp 018 '�`, March 15, 201 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW RE VI W REVIEW REVIEW REVIEW REVIEW DATE n RECEIVED ` 1 DATE COMPLETED Rev.//ZU14