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HomeMy WebLinkAboutBuilding Permit Application All APKICABLE IN/FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ��tt Date: / C "/'� Permit Number:_/,l �I■■ ■ ■■■�■ RECEIVE Building Permit Application . OCT 2 2 205 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: Address: MCC DulCzP—M1 Legal Description:_,,1 'C !-al t5 FW M( E21 k 411 t�`�' 1 a Property Tax ID#:LZ 0G- E00 —o I 'm --GCS© -q Lot No. Is Site Plan Name: ,,,���o' Block No. 41 P' Project Name: ?A C1 l.�1eVe,10„t t Setbacks Front Back: Right Side: Left Side: lfsfc.c, like far 1 11k2_ attsraa.e joor-- 16Y97 "� 1I- o itiona work to be performe un er t is permit-check all that appy: _Mechanical _Gas Tank _Gas Piping ^Shutters ✓Windows/Doors Electric _Plumbing _Sprinklers ^Generator Roof Total'Sq. Ft of Construction: '' {{ Sq. Ft.of First Floor: Cost of Construction: Utilities: —Sewer —Septic Building Height: Name Cielmd Name:_ �4Jrqunna Li � Address: 14200 T111c '12eal Company: MM E lice oC _eQ b dhe( ec;rior Gonane �- City: State: FL Address: i 108 _r0Maliac3k �r Zip Code:r t.J( Fax: City: Z'rictian State: Fl Phone No. Zip Code: 3Z937 Fax: 3,Z1- 777-_4-73q E-Mail: Ill Phone No._ 772-337-,V4170 Fill in fee simple Title Halder on next page (if different E-Mail: tiu sS' au» a whoa•c awn from the Owner listed above) State or County License: ' ( If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. t .� NO Y _ 4trt x e DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: J 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. Signature of Owner/.-Agent/Lessee Signature of.;Contractor/License Holder STATE OF FLOR&VO STATE OF FLOR�t / COUNTY OF COUNTY OF V The for oing instrur r tas acknowledged before me The foLrgoing instrument was acknowledgledd before me this d — �,20/ by thi _day o 201st by S Na person kn edg9n } (N me of person ckn wled ng) ( gnatu of a P blic-S at of Florida} ( gn tur of a Pu lic-State of Florida) ersonally Known _O roduced Identification Pers o ly Kno OR Produced Identification e of Identification Produc d ��x_ " of I ificatio roduced .. A, BROOKE S7IGETI r'a t SZIGER * MY COMMISSION#Ffi /� '*' M. MY�MMISSION f#FF2446 omm n No. mail EXPIRES:June mission No a1 I June 25,20% 25,2019 ,�•... RES: 1it,t Banded Thru Notary Public Linda ra ro Notary Pub�C Und9 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.