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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONz All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEP i i_u Date: Permit Number: I I I' M b f SCANNED BY St. Lucie. Countv RECEWED M0W_ _• Building Permit Application NOV 1 2017 Planning and Development Services PERMITTING Building and Code Regulation Division St. Lucie County, FL 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial _X Residential �1 PERMIT APPLICATION FOR: Address:.. ' Legal Description: Property Tax ID #: L - 1 Site Plan Name:% Project Name: Gk Setbacks Front Back: Right Side ,J6 cJAss = p� C�60,84(' Left Side: I -DETAILED DESCRIPTION OF WORK: CONSTRUCTION INFORMATION: itinn= I %Ain rV to ha nZr n r mari i i nfiort ¢ normrt—r or T r.t inn v —Mechanical — Gas Tank _ Ga "'Electric,.,,.. -Plumbing, _Sp Total Sq. Ft of Construction i Cosf.of Construction; $ _ 2• , ,; 6v Lot No. Block No. piping '``'Shuttets'''- t'• Windo>vs/Doors nklers_ Gene�afoC'"' Roof,+ _ t Pitch ;. \ h 4 Sq. Ft. of First Floor _ .._ Utilities: —Sewer —Septic Building Height: OW LESSEE; CONTRACTOR. Name ri✓ R Namei�OS/L fl �GtoO Address: %-f-0 -O-ZC04 Company: City: �EvSP� -1ACA State: A Zip Code:.3 0 S Fax: Phone No. Z ("71 70 %367Z Address: ) SF ©x &fiuy City: Zip Code: -5119 Phone No -7�7Z ` State: at]19 Fax:77Z -76 f -0103 E-Mail; —� Fifl in fee simple Title Holder on next page (if different from the Owner listed above) E-Mail 066 1674—P 40L -<fogm State or County License O Zq If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. UCJru lV Crc/ ENU 11-4 CCrc: _ lvoi HppncaDle MORTGAGE COMPANY: _ Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: Phone: BONDING COMPANY: _Not Applicable Name: 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 commencinia work or recording our Notice of Commencement. Signatur of Owner/ Lessee/Con ctor as Agent for Owner Signature. of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTYOF ///. COUNTYOF lAf The f9ligoing inst n a acknowledged before me acknowledged day The forgoing instru t s knowledged before me 3o 0 � this of 20 this day of 2d7 by (Name of person a �g & gir**ryPubAcStetedFbAde Greer Bh&Mth a of Won acknowledging) 9927090 State FkmCe =JtC2.:02J18f20F2F0/Usa IrkUsa 4ignature fMys� NofelY Public 0 Greer Bharat_ a7a of Notary Pu ic- State of Florida) (Signature of Notary % a mt ozo an 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 SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED nev. //ZUl4