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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INF ST BE COMPLETED FOR APPLICATION TO BE ACCEPTED t� Date: I Permit Number: --- RECEIVED 10l 0 6 M 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 4 PERMIT APPLICATION FOR: Ar '4 e e__. PROPOSED I'N"PROUEME TtOCAT1U', Address: _76 62 �q,1� �T ` DY �T �ucr�p �-X-1 Legal Description: /�� 3 J61C4c �� /��/�Y �✓/\ 611141 Property Tax ID#: '— J — Lot No.�� Site Plan Name: Block No. Project Name: Setbacks Front a.�j Back: Z Right Side: -7-Jr Left Side: 157 DETAI';LED DE�SGR,IPTtON OF WOR1K: 1 I i?-e C� , „ l�i� Need Aewoc aro on J `?,er ,'y►�ti�4 r O fro pe r TJ Ion a ro �r I-Ine a ° ���� ra r� L i' e _YD - 8TRUCTl@ -,N`FORMATIN,N: Additional work to be performed un er t is permit-checkrherk 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:$ CO0_©d Utilities: —Sewer —Septic Building Height: ®WM1Ngffi E-SSE Name U -O - 1 Name: Address:�Gi Company: City: I=L �Jy State: Address: Zip Code: Fax: City: State: Phone No. �� °� - l0 3 -336 Zip Code: Fax: E-Mail: Phone No Fill in fee simple 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. F S�l1PPLEMfNTA� C©NS R4UCTIQN LIEN LAW INFOR,MATI®lil. 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 before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commenctag work or recording ?our Notice of Commencement. Signature of Owner/Agent/Lessee/Contractor Signature of Contractor/License Holder STATE OF FLORIDA ) F STATE OF FLORIDA COUNTY OF 11 COUNTY OF The forgoing instr ment was acknowled a ore me The forgoing instrument was acknowledged before me this ay of 20 by this day of 20_ by (Name of person acknowledging) (Name of person acknowledging) �1 (Signature of No ry Public-State of Florida) (S• nature of Notary Public-State of Florida ) Personally Kno Personally Known OR Produced Identification Type of Iden tifi tip ""n,,� ANGELA M HUFF a of Identification Produced . a Notary Public-State of Florlda Z p d • •s ommiss on#FF 234730 WN% M Commission No '-,, ' ,` yComm.ExpirS y 27120 Commission No. (Seal) xh a )Cr 4 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.