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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED a Date: Permit Number: 5 4 1 rJ r0 . . " RECER'70 SEP 0 9'1015 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: K OD F PRtaPOSED INiPR®VEMENITLOCATION: Address: s3 c)`1 E C 1A b P l VvP_S Legal Description: �JQ L I 7�Fj t L PhCx6,0_ I S� Property Tax ID#: //3 a` - SOD- ,Q 1��- Q��' g' Lot No. Site Plan Name: Q-S 1 i's 4'AC4_0 Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DE�SCRI.PTiION O'F U,I/OR - Yri0 U� Q_5'/)64A0©P1 A)& -1-0 5 L)e.) 1 EC/C AIL © FF 1-ecK CONSTRUCTItF INFORMATION: Additional work to be pertormed check all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Construction: ��, y Sq. Ft. of First Floor: Cost of Construction:$ / 7 `J�,. (�y Utilities: —Sewer —Septic Building Height: 0,1NNER/ILE�SSEE: CONTRACTOR: R.76PAIM7M Name !L a s Name: 1!5Ar.,5 O4Llev✓5 Address: 530 �C110 !0/nes 69 /4/49157-- Company: City: ISe Statezx�-_/- Address: !0d 264' Zip Code: 3q el S/ Fax: City: State:FL Phone No. ylP / 3//(p Zip Code: ,3,y 97 !c Fax: el E-Mail: .4//Jv- Phone No 77Z 701 /'3 5-Z Fill in fee simple Title Holder on next page (if different E-Mail CO e_zlov/6 1000/-'��6-!r✓L��`1�1�-1G from the Owner listed above) State or County License Evalue of construction is 2500 or more,a RECORDED Notice of Commencement is required. S1J P' EMENL CONSTRUCTION LI' N LA INFORMAT 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 Associationrules,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 c.birri%encing work or recording our Notice of Commencement. rs i-Aature of Owner/Lessee/Agent Signature of Contractor/License Holder STATE OF FLORIDA- STATE OF FLORIDA COUNTY OF hnd 10n !2i IJPA— COUNTY OF The forgoing instrument was acknowledged before,me The forgoing instrument was acknowledged before me this day of S2(Ae mbe�r ,20_6 by this day of 20_ by (Name of person acknowledging) (Name of person acknowledging) J GX igna ure of Notary Public-State o Florida) (Signature of Notary Public-State of Florida) ` Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification of Identification Produced I(ARLAB06El3 Pro ced _ NoCommistary sior�#FF149 e,State of F Zrlda Commission No.�'/ (� I) ission No. (Seal) My comm.expires Aug.1 , 8 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.7/2014 RECEI\'=D SEP 092015 SOPP,LEM11VENTAL CONSTRUCTION LIEN LAINFORMATION 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: 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 accessor other non-residential use WARNING NER: r fail"Arz -Reco a Notice of Commenc ent may r It our paying ice for improv ents to you ro ef�y.A Notice offWommencement st be rec a nd posted on th jobsite bef the first ins c I If y inte brain financing, nsult wi a or n a y fore co m rdin No of Commence ent. s re of owner/Lessee/Agent6�T av�7 re of Contractor/License Holder TATE OF FLORIDA STATE OF FLORIDA OUNTY OF �T v COUNTY OF The fo ing instrument cknowledged before me The forgoing instrument was cknowledged before me this day o 20 Eby this_Y day of�2 e>v 20 by > - 0 (Name of person acknowledging) OtQ (Name of person cknowledging) ignature of Notary Public-State of FlWida) (Signature of Notary Public-State\4 Florida) Personally Known l/R Produced Identification Personally Known L� O Pr d e kation Type of Identification Produced Typ MaLlUl I r1UUULeJ__ ,�o,.r� G91L A. Commission o..�• AIL A.P91�, Co ° o r i� tate of Flora ) •. y _; •. Notary Public, State,01 Florida _My Commission ues Jan 4. .•= fires Jan 4,2018 '•;;�f o?� Commission 8 FF 074781 �'• ° Commission#FF 074781 Revised 0 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER,..' REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS