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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ( r Date: O — Permit Number: 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: PRQFO, .S:ED,� I'PRO��E1i1/,I�EN �L©CATi10 „�, __ Address: G c. s Legal Description: Property Tax ID#:3� D 6 I3( Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DE-NAILED DESCR9PTC® F U1/OR,K: CeC,Pr G c! 0111 :11111 ll:liiiiii��li��,ll:� 'W-1 pi C®N5TRUCTION INIFORIVIATION: I I 1111=11_ itiona wor to a pe orme under this permit—checK all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Constructio Sq. Ft.of First Floor: Cost of Construction: $ 150 Utilities: —Sewer —Septic Building Height: ry ®WtNER/LESSEE: C®.NTRPfOR Name Name: Yl vi Address: Company: City: /-C Ill State: Address: Zip Code: Fax: City: State Phone No. Zip Code: b Fax: E-Mail: Phone No T 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. S1UIPPLE�MEN1i4L CO,N5TURaC" N LAiW NtFrO�R,MATI�O�N: 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 commencin ork oTTtAcording yo r Notice of Commencemen . ignature of Ow L see/Agent Signature of Contractor se Holder STATE OF FLORI STATE OF FLORID COUNTY OF,—> , COUNTY OF The fo oing instJil�ment was acknowledged before me The for oing instru nt was acknowledge -before me this day of(JG.ti. 20� by this Zing of 20_ by t q . a G 11� of person ackn ledging) - (Name of person ackno le ing) (Signature of Notary Pub' -State f Florida ) (Signature of Notary Publip-.State of Flor' a DAWN MILONE Personally Known OR Produced Identification Personally Known R.. umetir dl MIiFiicati__t FI Type of IdentificationType of Identification j =My Comm.Expires Mar 22.2017 tl,fl fir; Produced �4Y N Produced �:"_y„ ,,• Commission # EE 87:Flt JQ4NA `B�i� Notary Public-State of Ttorida ����"` Bonded;Through National Notary r,ssn. ; , � .�,�;_ Commission No. ' :._My Comm(SE0t)s Mar"22,2017 Commission No. w ea Commission#EE 877571 `.., Bonded Throu h National Notary Assn. REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.7/2014