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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ,\ ! d I i 5 Permit Number: 4:, ;��� ., r RECEIVED NOV 10 2015 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 r PERMIT APPLICATION FOR: < NOW-1,006 INPROUEMENT LOCATLON: Address: 'cfza ZQ -ff—(& Legal Description: PropertyTaxlD#: 3y'L�� Co� ^ 6 �1 - 600 ^co Lot No. /7 Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAIILED DE�SCR+IPTION pF i1el"d a as !/0 r A,3' CO STR+U�TI0IINF©RMATION: Additional work to be pertormed under this permit-check all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Construction: /.ZX Sq. Ft.of First Floor: Cost of Construction:$ Q 0 Utilities: _Sewer .._Septic Building Height: ® yr, NER/LEASSEE C®NTRACT®R: Name X re.aI- x Name: 1�c� vir C/e�� ti y/9(�a r�PPiN�Gp_C/ Address: G//® La. VITT , A- Company: City: -J-/'. /z,.c G State:FL Add ress:,;`O WL,-, ,'vz S"�<res -&,j— 10'e-if Zip Code:3y,?-;f,z Fax: City: oca0 State: /` L- Phone No. Zip Code:_Lz Fax: E-Mail: c f - Phone No -7 Fill in fee simple itle 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. SUPPLEMENTAL CONSTRUtJ.CTI7N LhE7N LA INFORMATIQN: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLEHOLDER: , _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/Lessee/Agent Signature:of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 'S ar. Lv C o COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day ofO0J 20 6 by this day of 20_ by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Publ State of Florida) (Signature of Notary Public-State of Florida) . NNA GIVENS y i,�t�a h °`F1ot,0�6 ersonally Known OR Produced Identification Personally Known uced Ide��� Type of Identification ,o�ay P"s;%; Aowa m Expires� 8�6 ype of Identification Produced F t-b L ;r���•o;My�ommisslhNa 10na1Notary ps5 ' oduced Commission No. L ' e.�ded�h( Commission'No. `(Seal) 5 ,, , . REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE- , -MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE , RECEIVED DATE COMPLETED ev.