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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 16Z Date: - ' Permit Number: Z 0 6 q RECEIVED - Building Permit Application Planning and Development Services - SEP 11 2015 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: 000-0 PRaP4�SED )NPR©UEMEN >_OCA I®;N; Address: .6� 9z4a'✓-JA, 1.4 /�Sl� (, ;32-/1572— Legal Description: 1,4 j;c4N,4 11.,-CA C� "�tl� � � ��_�1�� �Or2/.�9� -l'72Lf7 Property Tax ID#:�/� �7(D 662 U Q/„�3 Wee Lot No. Site Plan Name: SJzvcx�G Block No. Project Name: Setbacks. Front Back: Right Side: Left Side: DETAILED DESCRI:PTI®N OF W©RK: A'VD i�CL?Ti cif/.LJ �' �,�• CQNSTR�UCT(ON INI=O'RMAT�01�: '.• s Additional work to be peffo—r—m-e-d under this permit- k ec a t at appy: _Mechanici�l„x:' `` =tGas.Tank Gas Piping _Sfiut e'r�5 .:Y •_-Windows/Doiirs —Electric Plumbing —Sprinklers _Generator Roof r TotalS,q,,Ft•of Construction /� BTU Sq. Ft.Qf First>F1ooc: Cost of Construction:$ c$��/(/�� co Utilities: —Sewer —Septic Build ing Height: O�UVNER/LE�S�SEE.: F: GONTRAC ®R:: Name �2V �'� eAu L/aw Name: ,fir i% ca�Jl9u it Address: Company: - yv Gc:Y� LGCi City: 1?S'L, State:1-:L Address: 33 2l oc4!54tis-pc-w, /4VL__ Zip Code: Fax: City: Z6�PC Stater Phone No. �Zf g3-) 2dl q Zip Code: 3,1992- Fax: z l E-Mail: Phone No `777 ?UO I Fill in fee simple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License lb If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SlJ' P EIVIENTAL C©NSTUCTIDN LI,E�N LAW INF® MATlON: 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 obiain•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 postedon th ' bsite before the first in ection. If you intend to obtain financing, consult with I er or an attorney be :; commencingr r re ordin our Notice of Commencement. �: 0 Signature of wner/Lessee/Agent Signature of Contractor License o �� my m STATE OF FLORID a x�a STATE OF FLORID w` COUNTY OF 2 aH COUNTY OF _ z i= �Cnn m rnT 2 The forgoing instru ent was acknowledged befo �Jz ir The fing instru ent was acknowledgetl bef n m this LL day of 20Z5 by ��= this day of 20 by ` ,J K m p V Rl -G ,A�e yen o �N11 Cn OqMn va (Name of person acknowledgi g) (Name of person acknowledging) (Signature of NolUry Public-State of Florida) (Signature of Notary lic-State of Florida) Personally Known L-o"� OR Produced Identification Personally Known Produced Identification Type of Identification Type of Identification Produced Produced Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.