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HomeMy WebLinkAboutBuilding Permit Application / ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED e� Date: l Permit Number:41111111111 yO� O "z ." _,..i • ECS VE kap Building Permit Application AUG 1 9, 2015 Planning and Development Services Building and Code Regulation Division PERvi" .,. 2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie Coi!,l`:y; i '-- Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential _ PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION Address: 5 S 33 4 -ST rat Pl Legal Description:_WRYW00 h MAX011 Q L k 3 1�AJVb o S/AC 0,010 -Arcl li /o - 9 .Z &1YV ?f 340.3 - 17 4 Property Tax ID#: 0 LY t-f --4,pd - Oa Yd - v o o Lot No. 14, 14 � ly Site Plan Name: Block No. 3 Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED: ES,CRIPTION O;F WORK L 1Mr4 ao-o li / +o i rb C I V C e P)e w --k (e_ S ki J w 'Q✓ -,L CONSTRUCTION INFORMATION Additional work to be performed un er t is permit-checka apply: ❑HVAC Gas Tank as Piping Shutters Windows/Doors Electric ©Plumbing SEldeneratorprinklers Roof Total Sq. Ft of Construction: Ly 0 Sq. Ft.of First Floor: Cost of Construction:$ 5-570• Utilities:FISewer 0Septic Building Height: OWNER/LESSEE '; 4 ;;CONTRACTOR 1 . s; Name _VI o G Kci� fool) frrc.11 C Name: rl S e Add' ! 1157 S i3 r d Sr��r�rLfi Company: Ci-AST 1y CDA S1 i1j, id e,-!' u f7l City: 1-'o� State: L Address: �f r�3� S'1 — ,D/ ver i AeQ c4, �L Zip Code: 3 V OIL/ Fax: City: Veto 13 FAC Ik Stater Phone No. L4(PN- -97- 3 9 Zip Code: 3 2-9 G q Fax: 773A- 3_9 V_ Y6 6 J E-Mail: Phone No. -7702- 3 6 D- e/4P C Fill in fee simple Title Holder on next page(if different E-Mail: Cd 4 I e S d- Q eD-*1 cq t� A)e from the Owner listed above) State or County License: C Gl ISO 7?W l a If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRU TION LIEN LAW INFORMATION'; 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: 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. S 4Si�nyature of Owner/Lessee/Agent Signature of Contractor/Lic er STATE OF FLORID STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instrument was acknowledged before me The forgoing instruwas acknowledged before me this i'l day olgmsl'c,� 20 W by this 16k day of ent •� 2015_ by cu (Na of person acknowledging) (Name of person acknowledging) (S' not re of Notary Public- a e of Florida) nat re of Notary Public- ate of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced Type of Identification Produced 1. gyp 16 LASHAHNA INGRAM Sao U*� •; Notary Public State.,pf Florida `2C3 p6��,� LASHAHNA INGRAM ; * ; My comm.Expires DeFA Notary Public-State of Florida ' ="r oma; Commission#:FF 47 249 f My Comm.Expires Dec 20,2018 '%�- 'Do-" Bonded throughNational I ao�I��s •,,Fo��t�` Commission#FF 177249 249 Bonded through National Notary Assn.