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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: \l�� \5 Permit Number: RECEIV70 AUG 112015 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 /d PERMIT APPLICATION FOR: To Select from dropbox, click here C G PROPOSED I'NPROVEVI'ENT LOCATION: Address: 3(77 dk-1,#- ��/✓ Legal Description: Z4Kf. °Wooy /�d,c l- !/li Ir7— � o776Z Property Tax ID#: /301 — 160e —01fil ''aac® d Lot No. 13 Site Plan Name: I (li�//�' Block No. .9141, Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED QESCRIPTIO-NOF WO.RK`. A/C CHANGE OUT EXACT,REPLACEMENT 3 %t/ — 1 1�1J//y4 CONSTRUCTION .I_NFORMATION: Additional work to e e ormeun EFI is permit—check a appy: ❑✓ HVAC � Gas Tank Gas Piping In Shutters Windows Doors 1-1 ❑ p g ❑Windows/ Doors ❑ Plumbing Sprinklers 11 Generator F] Roof Total Sq. Ft of Construction: Sq. Ft.of First Floor: 115cf(/ z Cost of Construction:$ Utilities:D_Sewer D Septic Building Height: OWN ERKESSFE: CONTRACTOR: ' Name Name: MARKAVINES Address: D5'07 �/o&77/ 17IVtl Company: AZTIL City: /—-,7/ L`' State:FL Address: 2540 S MILITARY TRAIL Zip Code: 50V Fax: City: WEST PALM BEACH State:FL Phone Nol,?7;2—) WK,— l©ya Zip Code: 33415 Fax: 561-434-0018 E-Mail: Phone No. 561-433-2197 Fill in fee simple Title Holder on next page (if different E-Mail: SAMPOLIT01 @GMAIL.COM from the Owner listed above) State or County License: CAC049253 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. .SUPR�LEMENTAL CONSTRUCTION LIEN LAW INFORMATION ., / — pp MORTGAGE COMPANY: ' DESIGNER ENGINEER: Not Applicable Y: _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 commencing work or recording our Notice of Commencement. 41-/Z/o� Signature of Owner/Agent/Lessee Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY 01`_,, .Alw 15:5_'Al C"a CIvas7 COUNTY OF PALM BEACH COUNTY The forgoing instrum nt was acknowledged before me The forgoing instrume t was acknowledged before me this--)'/ day of r2 20F/_5j by this I! day of �02oF731 by (Name of perso knowl i (Name of person a n I ging) gna r of t Public- a e of Florida) :Type ur o otary Public-State of Florida) ersonall wn OR Produced Identification y Known -Y OR Produced Identification Type of I tification Pro uGYP.:••., of Identification ProdB WARD GIFFORD Commission No. �`,. = MY( MISSION#FF07ommission No. MY �t��j °P' r. _ ISSION#FF077427 EXPIRES December 17,201 `�' .°. °-FI.- EXPIRES December 17,2017 407 398-0153 1153 1`9IdridSNotaryservice.com Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED