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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: � 7'• )J Permit Number: 14 2015' Building Permii'App"lication ° 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: f?fi©POEli mil fNPR®1/E11lI;E;T IJ►C 1'IQORION NO Address: 36y wkm It Legal Description: Z',� 5y n3 — 210?-- Ol ZO MaQ Z.•fl, :* XRO lam' Or. PALM &AQJ!sSN S B L K I o W *a Ft.(. (nr- c Crr Property Tax ID#: 2�65 9-02 01210 00& Lot No. Site Plan Name: Block No. Project Name: ® '- AIM RIIIKVS(�&. Setbacks Front Back: Right Side: /a Left Side: DETAILED DE�SCR�I!PTIO. OF WORK: � �� �►��'� lid "���t�x C®NST l)CTI(? INFORfVfATION: NMI Additional.work to be pertormed under this permit—check all that appy: —Mechanical —Gas Tank —Gas Piping _Sli'utters _Windows/Doors Electric Plumbing —Sprinklers Generator _Roof Total Sq. Ft of Construction: 4W ry0 Sq. Ft. c First Floor: Cost of Construction: $ f5(J00L Utilities: —Sewer —Septic Building Height: ®1NNEE�SSEE �4 �E®NTR'A OR': � _ a ° Name Name: Address: ,Xq Ai EM pry Company: City: -FT I)ERGs State: Address: Zip Code: 3f f2— Fax: City: State: Phone No. 772-- WGO ' `f*75— Zip Code: Fax: E-Mail: Phone No 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. SlJ' PLEMEN A CONS RUCTfON Li" LAW IORMATitN: DESIGNER/ENGINEER:ICER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: IFFY 43WCiAT" iXC. Name: AddrQ- sWp 130K 5yk Address: City: �°1x 0 Nite State: G City: State: Zip: s C Phone%M 6TC—'76c,a 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 theppermit 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. ignature of- e L Signature,of,Cvntractor/.License Holder . TATE OF STATE OF FLORIDA . COUNTY OF `''''` 's ' COUNTY OF The fgrgQing instru ent was acknowledged be rrp Mit-,= The forgoing instrument was acknowledged before me this V day of 20/1 b 2 F3�-X this day of 20_ by Mg r� M °'zc oh n -T,ep-ym too (Name of person acknowledging) o (Name of person acknowledging) N �N 1 (Signature cootary Public-State of tlorida ) (Signature of Notary Public-State of Florida ) Persona n OR Produced Identification Personally Known OR Produced Identification Type o Identifica i n // Type of Identification Produced vC/L C Produced Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE - MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Te—v.7/2014