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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMn.�rED%FOR APPLICATION TO BE ACCEPTED\._f Date: ✓> 3 D%�� Permit Number: SCANNED BY 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 Lr� i3'o5`� 2-). Building Permit Application Commercial Residential _� PERMIT APPLICATION FOR: " ! ' 0. Address: `bs062 ylbuRAlull/ Cr 6'•S,L,.�L3�(9�Z Legal Description: Prooertpif�' , # �1 - 1 7 ©�j -' , ©(� Lot No. Site Plan Name: Block No. Project Name: L.2e if in r 4ez g EAA Setbacks Front Back: o A-Y 4 ; v-L ca';r T Right Side: Left Side: 5 1 �r- L .9�k`K , 25-OD P5 AUUI uU l Id WUIK LU Ue glen lII l l IeU UIIUeI LIM F/e11I II L— 111CCR d I I UIdL 6pply. _Mechanical _ Gas Tank _ Gas.Piping _ Shutters —Windows/Doors Electric —Plumbing _ Sprinklers _ Generator _ Roof Total Sq. Ft of.Construction: I a'-J Sq. Ft. of First Floor: ) L O o + Cost of Construction: $ �/, % Zri 0 D Utilities: _[Sewer I/Septic Building Height: g WNE /� SS E: CONTR CTOR: Name (vli ik Sns SuJ ln�' NametG r _ }j u.� IL M e f- Address ; y t' D b V r.` Com an . Ak�Kr Chi sT0, Address ,:3Y6 I u% \ n A-9 Co w M'^ v` 7 -s ,.y.. State: City!, P Zip Code: 3"`V%SZ Fax: -.Phone No. i `1-1 Z 23' l City,-" i! :-S.'( Zip Code: 3 y9 J-2 Fax: Phone No f-772)2z/Q- e.'fol State:��- e 71- 45 1 E-Mail: UTA Fill in fee simple Title Holder on next page (if different from the Owner listed above) E-M ail OL AA m oC Ce kg`_Co� 4PI State or County License r&C', If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. SUPP • MENTA CONSTR N LIEN M INFORMRTiION: Mill- DESIGNER/ENGINEER: Name: _5r-r-- e'A C.9 0o _ NotApplicable P. E MORTGAGE COMPANY: _ Not Applicable Name: Address: 9S(o s,W• 51, City: Zip: _1L sr Phone 7 /11a Al State: _�L— Address: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: Name: _ Not Applicable 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 ppermit 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 commernt riR work orxecordine vour Notice of Commencement. /) T , � 1._w �. �� p...�M1:.as�'ann.. dk I•i'�.. P ,.< i-. r� Tvrvv_�q,r,.�___ Signa re of Own / Lesse SignatureXf Contractor/ kense Hol a -'-�-� s STATE OF FLORID A STATE OF FLORID�Y1� COUNTY OF COUNTY OF The forgoing in tru nt was cknowledged before me The forgoing instrument was acknowledged before me ti iQbday of 20 y this ,3b day of _'Y 0 r }1 ,20N-by (Name of berson acknowledging) 1 (Name person acknowledging) (Sig a ure of Notary Public- State f Florida) a Notary Public- State f Florida) / Personally Known OR Produced Identification Personally Known -OR Produced Identification r� Type of Identification Type of Iderl1i ca on Produced Produced ,•��•� DAWN MI LONEl7d5mission °� "�� •`�` 9Jpy Public •State of Flo Commission No. :, •( "-" "'' a�WN MILONE No. �S'�'Ua,°�. Noe y m. ExplresMar 22, ��=•` Commiselo�f �.For.�o°;,• ;. v • , E Y Ilc •State of Florida e ° MY Comm. Exptres ° sM�EE'87757 A Mar22 p a iona Wary Assn. "°°°��5�•°°,,,•, Bonded Thr E 877871' u REVIEWS FRONT ZONING S P R IS L'ANS VEGETATION Pl�➢AVgsSn: COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW R I DATE IN RECEIVED W DATE COMPLETED j (iU1 ttev. 7/2014