HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: I\ Permit Number: 151 - 1 3�0
RECEIVED NOV 2 5 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
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address: -�/a Kear-nev Rd-
Legal Description: i4e
Property Tax ID#:3�10-Lo; --clooy-C)O03 Lot No.6
Site Plan Name: Block No.
Project Name: L�cGl' nlf_q
Setbacks Front Back: Right Side: `left Side:
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Additional worKtoDe oertormea unclertnis permit-check alFtUt apply:
11HVAC 11 Gas Tank Gas Piping RShutters windows/Doors
Electric ED Plumbing FSprinklers FIGenerator Roof
Total Sq. Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ 1 19 1 Utilities:11 Sewer 01Septic Building Height:
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Name_LLch&eJ LAQG1'o1kq Name:
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Address: Vfd_�Te_kl Company,-. Co 00j
City: (,p State. Address:
Zip Code: Fax: city: I-L',*-t-"k JDL-��C-'CJ� Stater,--
Phone No. i7_"_';00 j 91 S_ Zip Code:31tJ I Fax:_51.4 -'a55%,C/o F9
E-Mail: Phone No. 5-b/- 'R �o5",a),
Fill in fee simple Title Holder on next page if different E-Mail:
from the Owner listed above) State or County License: C G (I a2cFi 3 1
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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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: c/kot Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 per 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 J
in accordance with the approved plans,the Florida Building Code's 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.
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gnature o wnerrLessee/Agenit ature of Contractor/License Holder
STATE OF FLORIDA ���;��°4� J"SR80UDRfOu STATE OF FLOR).QA
COUNTY OF MY COMMISSION#FF 12COUNTY OF Q I
8928 C
N, o� ne 13,2018
0 a` Bond d1b cudgel Nobry Smkes The forgoing _
The forgoing instrument was ac kn�f�i�edged More me g instru ent was acknowledged before me
this 1 I day of/�cX12�+h22 20 �y thisp33•day of U• 20 1.�by
1 Jc m?s D QJII_S
(Nf person acknowledging) (Name of person acknowledging)
am
Nature of NotaryPublic State of�Flor-ida) (Signature f Not P=ublic-St, a of Florida)
—iy.nv4x.....,:..., v- ,-.;:-ivYn;-sT,;r••..« .,- f-f;':.^..aa..rcrr •r.�.r•
ersonally Known ~ OR Produced Identification `� Personally Known oduced Identification
Type of Identification Produced 4,m, Type of Identification-Produced
•: Y. - ANGELA YOUNG
Commission No. (Seal) Commission No. 6
OOPAIyJISfUA4-EE998835
;np.'. EXPIRES April 12,2096
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS