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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INPO,M)l1ST BE OMPLETED FOR APPLICATION TO BE ACCEPTED �/ Date: 11 Permit Number- c I a N.- ,,17 a Building Permit Application 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 PERMIT APPLICATION FOR: P'RDPOSED INPR©UEMiENT LQCATIC}N: Address: G� 4q2 Legal Description: eS TI1 07 l f ) ,Q(r:� ZT5 an Property Tax ID#: tD`^ Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: t DETAfLED DE�S'CR+IPTION ©F VtIORK: R UJ eel i O eAc:) Abe- boL�(5C . CO'NSTRIJCTI®N hNFORMATION: ---- Additional work to be performed under this permit–check all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters . _Windows/Doors' _Electric _Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Construction: Sq. Ft..of First Floor: Cost of Construction: $ �® Utilities: `—Sewer _Septic Building Height:-------- N a m e eight:Name Address: � W Company: .`s`:L City: P , Stater ,Address: Zip Code: I . Fax: City: State: .Phone No – Zip Code: Fax: 0 E-Mail: o Phone No Fill in fee simple Title Holder on next page if different E-Mail from the Owner listed above) State or Co ty License If value of construction is 2500 or more,a RECORDED Notice of Commen ment is required. SIJPP .EMENTAI.CONSTR_IJCTION I.IEfN LAW INIFOk ATIN5. DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: 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. 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 befor the first inspection. If you intend to obtain financing, consult with lender or an attorney before coFn encingwork or recordi ouO Notice of Commencement. ignature of Owner/Lessee Agen Signature of Contractor/License Holder TATE OFF ORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The fqrqoing instrunakW was acknowledged�re me The forgoing instrument was acknowledged before me this day of 20_Ly this day of 20_ by (Name of person ackno ledging) (Name of person acknowledging) P1 4A (Signature of NotUry Public-State of Florida) (Signature of Notary Public-State of Florida ) Personally: nq � ]1da on Personally Known ORProduced Identification T e of Id • '' LAM HUFF Type of Identification YP Notary Public-State of DZ duced Produced 34My Comm.Expires May 2 (Seal) Commissiorlf;�o':"' Rodedthrouohry�lonal[+loZ9Commission No. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.