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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ,• 1 Permit Number: I � 1 L W r RECEIVED Building Permit Application Planning and Development Services MAY. 21 2015 Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATIDN FOR: Address: 1,�� (�L� �P— 5.4. Lucke. VL Legal Description: Qk i P 5 Me, LQ� 11 , oZ. ® 3g - 05T a �f qac ' Property Tax ID#: ® 33 — v 6 =o "0V 0` 5_ Lot No. Site Plan Name: Block No. Project Name: 41W �!� S Setbacks Front Back: Right Side: Left Side: among= itiona wor to epe orme under tispermit—check all . t atappy: _Mechanical _Gas Tank _Gas Piping `.',Shutters _Windows/Doors Electric _Plumbing _Sprinklers .`' Generator _Roof Total Sq. Ft of Construction: NAAMWM4.. F• S Q. Ft.'of First Floor: Cost of Construction:$ © ' Utilities: _Sewer _Septic Building Height: f Name& V'�— ccs Name: Address: f Szt Vl e Company: City: f LItC oe- StateSEL Address: Zip Code: . �(��� Fax: City: State: Phone No.® Zip Code: Fax: E-Mail: _ SE? 0 Phone No Fill in fee si ply Title Holder on next page(if different E-Mail from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. LIM rNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable : Name: Adress: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: —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.. 1 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`ton 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. Sign to g w er Lessee/Agent Signature of Contractor/License Holder STATE OF FLORIDA - ,v"' STATE OF FLORIDA COUNTY OF _° '_ COUNTY OF The forgoing instrument was acknowledged beforrge The forgoing instrument_ was acknowledged before me this day o 26S7 by, $C g this day of ,20� by Hm (Name of person acknowledging) (Name of person acknowledging) 1A 'd h/A A 'fJ (Signature of NotYy Public-State of Flori a) (Signature of Notary Public-State of Florida) Persona own OR Produced Identification �� Personally Known OR Produced Identification Type of identi tion �� 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 ke-v.7/2014