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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: SCANNED Permit Number: OL/lJ' U1 Sy BY RECEIVED RECEIVED St. Lucie County Building Permit Application JUN 2 7 2018 JUN 2 9 2010 Planning and Development Services Permitting Department o iS.tttLucle Department County Building and Code Regulation Division St. Lucie County 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X. Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line v%nrwvr f PROPOSED IMPROVEMENT LOCATION: Address: 50/A_1/�Noah yjWwDta A1A, Un►+ 1402 ►=ort Pierce FL �LL9Uq h Legal Description: l ni li' Nlia \I txh Dun (-C)nC10M i6 i urn �k1 Property Tax ID #: Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: R9.0l0,c o9 3 sw\,k(n 90n cloocs wvm �rnp�c =gated c oofs- CONSTRUCTION INFORMATION: Ada itional work to be performed un ert ispermit-c eckall apply. OHVAC Gas Tank ❑Gas Piping Shutters © Windows/Doors _ 11 Electric OPlumbing Sprinklers Generator 11 Roof = Roof pitch Total Sq. Ft of Construction: 5 Ft. of First Floor: Cost of Construction: $�1�> Utilities:ll Sewer D Septic Building Height: O W N ERAESSEE: CONTRACTOR: Name 12 pasm IFYctan Name: 1 Address: nO� m3Si City: fto = State:C-�A Zip Code: 7)05i L.0 Fax: Phone No. C -2_( Address: P.)- ey-)X 171-5 1 City:!FCyi e( A ear Stater Zip Code: 3L�q Fax: - - Phone No. E-Mail: CQ M 0\I I `� ama I. corn Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail: O n 0 �T State or County License: If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: 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 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 OWMtR: Your failure to Record a Notice of Commencement mayIt in your paying twice for improvements to your property. A Notice of Commencement must be rey v ed and posted on the jobsite before the fir,,�t�*inspection. If you intend to obtain financing, consult w' ender or an attorney before commencink`work or recprdjng your Notice of Commencement. S1" atur r/ Lessee/Contractor Ngfor Owner ure Contract /Lic nse Ha der SrAl OF FL RID p SE OF FLOR DA 1 1 COUNTY OF COUNTY OF 71 11(�} lS✓�G e. The or Ping instru nt was acknowledge efore me The forggo�ing instrument was acknowledged before me this ayof 20��y , this-iSayof3:1 ). 201bby Cb- , nA i c;nael W1011rifo r) Name of p rs n making statement Personally Known � OR Produced Identification Name of pers n making statement I Personally Known A OR Produced Identification Type of Identification Type of Identification Produced Produced Paw e) (Signature of Notary Public- State of(Fl�orida) (Signature of Notary Public- State of Florida ) CommissionNo.r��I-1 ( ?)do ,,,,, AMANDA R26fM!ibFNQnS ' ' State of Florida :' k: v AMANDA ROSE BICommiss -Notary Public r6m on N GG 146214 c State of Florida-Noter My Com fission Expires Commission N GG 1 u,nasepti moor 9'�o„��p0� y ommiso on REVIEWS FRONT ZONING TATION S .2 COUNTER REVIEW REVIEW REVIEW REVIEW I REVIEW DATE % I F�..-t RECEIVED ( DATE n 7 COMPLETED -I Rev.8/2/17