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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: O `b1Permit Number: 1`�10' O Sqa SCANNED r`� s BY RECEIVED St. Lucie County Building Permit Applicati n OCT 2 6 20)a Planning and Development Services Building and Code Regulation Division ST. L-usle Go City, Pitrml3in® 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: l,c7Nyd0©� grC�1J dhd d 1P. f OR MRS t-01 )NPROVEMENT LOCATION: Address: /DU L/ L/ SDcxirJ D6V-0-- UnJ;I 501 I <��N/se,�/R 34G5q Legal Description: ezli �nIm1411 LIM &et /-V' -IL J29 L Md/� SAN�OGfUIarT�we�D.2��cs�C ��/PeGe558 91-11(Qeco2Ds � �57Cucie Cp�r, r� Property Tax ID#: / cJO p� - �d - OD �J- �D� Lot No. Site Plan Name: Block No. II Project Name: W I I'l l 4-fM UN Setbacks Front Back: Right Side: ' Left Side: _Mechanical _ Gas Tank _ Gas Piping Electric Plumbing _ Sprinklers Total Sq. Ft of Construction: CJ Shutters —Windows/Doors _ Generator _ Roof Pitch Sq. Ft. of First Floor: Cost of Construction: $ 6V U - Utilities: -Sewer -Septic Building Height: OWNER�LESSEE: CONTRALTO Name lA//0'am.... VrJ k Name: ,Pr `Q-l'y✓s f iei Address: 16 Q 41/ S 0"1 J 04;tAo- /9PF So l Company:.R.P&itj A 2C(gnld C s Nc City: -J�^;S-en1 (5c-Lj State: FL Zip Code: ? Ll q' 7 Fax: Phone No. I—) 2Z �Pd - 02, $q Address:,; 5 f -ec' City: R!OCA P✓ -60 Zip Code: Phone No Ck G L( State:£L _ Fax: - to 3 2- No 1 E-Mail:-�- In r I S r t Cwyy-41 C'6 VI-i Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail KePQ 1/4+(0N`�=G`1 1IJC-@ + �'lc/a�'� State or County License e GL ZZ (`l 3 If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. Ank SU FL ME,NTAI G a SFT++. CT(� LSE 1N N MNTI N: DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: 'Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLEHOLDER: _ Not Applicable BONDING COMPANY: Not Applicable Name: 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 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 commencing work or recording our Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent for wner ignati.i of Co tr ctor icense Hol 5Kr STATE OF FLORI COUNTY OF '��o.UC 1 G STATE OF FLORWA COUNTY OF The for instr men was acknowledgefi, before me this, day of L t/ 20-a by The forgoing instryrnen was acknowledge before me this L day of LAC Y 20Xby `(�A\'tc,ry-) <!_ a Name of person making statement. Name of person making stptement. Personally Known l OR Produced Identification Personally KnownOR Produced Identification Type of Identification Type of Identification Produced Produced (Sigrature o otaryP;bIlp§%0R of Flo pA LEE _ `M•, Notary Pohllo - State of Florida Commission No. `� e " �' Co Hlpn # FF 206852 �• , a; 'My comm. plres Jun 15. 2019 �fc ••�' %,'um,,` Bonded through National Notar Assn. y (Si at of Notary Publ' - ,r M „m„ BRENDA LEE FLORES '' "�o'•i -State of Florida Commission No. U �� � . `�: No! j89TIle _, � '� . omm sicn # FF 206852 o� My Comm. Expires Jun 15, 201 REVIEWS FRONT -i ZONING SUPERVISOR PLANS VEGETATION' •nn,,,na Bonded T ]MANGROVE COUNTER ` REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.8/2/17