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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETtu rOR APPLICATION TO BE ACCEPTED Date: /Noll • it his SCANNED Permit Number: l�6 I I — 0365 0T v St. Lucie County RECEIVED NOV 19 201.8 Building Permit Application ST. W Caan4y PArmittina 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 I PERMIT APPLICATION FOR: W\t`naJa�'*kou\_Cawa(S I Address: 970 S- Legal Description: Property Tax ID #: S 5 -55 (#0 1 � Site Plan Name: Project Name: 00 — t&M Setbacks Front 4A, Back:_ Right Side:_ Left Side: Lot No. Block No. _Mechanical _Gas Tank _Gas Piping _Shutters Windows/Doors ,Electric v/'Plumbing ✓Sprinklers _Generator _Roof Pitch Total Sq. Ft of Construction: 11727- Sq. Ft. of First Floor: 1?Zz Cost of Construction: $ 000 Utilities: —Sewer _Septic Building Height: x£3WidRftESSfE . .aa", .n-...-q a": a.ex-u..x L`s{x .,.-tg...� C(3PRF+CT©i ."e J•r - — 4 -Av.,.a _J-.�.z.,rv:ae .vun Name Ct, d .Dl IL Ulb Name:rr��� Addre�ss^:'K� �S cezn D64 � l$3� Company: f a l\cSt�w ¢x iLoEtS Con1—i3c�cT City: JPAA�Q11 CAzG State: �L Zip Code:�N CK i-,., Fax: Phone No. LPO-- Address:' e* Cc 17A WA`( c l c City: )' L, pfizl ,4 Zip Code: 3 331 L Fax: Phone No -115�r Stater E-Mail: Fill In fee simple Title Holder on next page ( if different from the Owner listed above) E-Mailg� i6s�ln C 21L.a1 n.aal • Cw�+ State or County License CiW— tzA Qp-76- .. If value of construction Is 2500 or more, a RECORDED Notice of Commencement is requires. al ui SI S.LIPf'L'LMENiAt�C �"S:'2? ud. NST C G3lt7yN C1 NtlA i1i NFia ^',nine+•' S ab+"w. �.'i65 -m .x-�YJb t"^'fs .n v."`" .Y'iv +i.'1P#M.i ...A .�"k" Y•Fi' 1£.v ca'x34('...�� l.n"i�-*��i{ v i }.�fi^-,v !i? DESIGNER/ENGINEER: Name: _ Not Applicable MORTGAGE COMPANY: Not Applicable Name' -Vto-0 f�tr roes 7r-,><,7 Address: P• 0- l5d p 01001 KO ,A400 Address: City: Zip: Phone State: City: D T b-., Aj r p2 r f- - State: �e Zip:-7hone:%6b-9aD-aoaO FEE SIMPLE TITLEHOLDER: Name: Address: _ Not Applicable BONDING COMPANY: _Not Applicable Name: 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 requeste&permit, I da hereby agree that I will, in ail 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 ct%mencine work or/rkmdinevour Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent for Owner re of Contractor ' e se Holder STgTE.OF FLORIDA STATE OF FLORIDA -D COUNTY OF COUNTY OF The forgoing instrument was acknowledged before me The rg ing instrumentedged before me f this 20 day of 5-eN(eV4 L o✓ . 20 i � by this day of 20 ( by C laI : �� v (Name of person acknowledgi ) (Nam of pers acknowledging ) (Signature of Notary Public- Skate of Florida) (Signature o ry Pub c- State of Florida ) Personally Known OR Produced Identification Personally Known OR Produced Identification TypeofIdentifica Type of Id con ,. Produced jti'ro"'.,, RICHAROE.SHAWVER of Florida Produced i'IUXN ... .. °re7____RRLENE ,. - a[e , 'e Commission W GG 243201 Commission No.:. o ?V. M Comm. Expirfsl�f.2G22 C CRISPMA '?`Q' NotaryPyypp1}"c ''jjfate o Commission No. n Commi$lo�i/ GG "Bonded through National NO My CommExires A Bonded through National N REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW" REVIEW REVIEW REVIEW REVIEW REVIEW DATE •% - RECEIVED _ _ DATE COMPLETED" •` Rev. //[u14