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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE I FOM ST BB OMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: s 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 PROPOSEDIMPRUEMENT LOCATION Address: 0 S_ G � Legal Description:Z-6L/ie ww--ePslLalk Property Tax ID#: © Lot No. J Site Plan Name: tog- Block No. Project Name: Setbacks Front Back: Right Side: Left Side: OE , 0 A I:'® ®ESCRIPTION jOF WORK AWN � OpcR/r�. S �c�©8S G�c�-,� 1-5 w�.�e. /� .�",� � u •ry c� 1819 V'v ) S t Pe 1qe4v0, rl� P CONSTR CtTtIONINFORMA�TIQN AdditionalWK work to ee orme under this permit-c ec a appy: []Gas Piping Shutters rs ❑Windo /Doors ❑Electric Plumbing 11 Sprinklers _Generator ❑Ro" Total Sq. Ft of Construction: SFt.of First Floor: / v Cost of Construction:$ Utilities:cnSewer 0Septic Building Height: W - �s aF ',� 6t t �' � .XT r a y s OWNER/LESSEE ,`� % .,°� w ; #'CONTRACT RT . , a Name Name. Address: ��,� - Company: ��++ City:G/4ly0.c4 P/< State.&47- Address: 2/(D )4 Zip Code:,'Yyf/!0' Fax. �� 7']� �� City: n ,/�. Stater Phone No. 7 fJ ��' Zip CodeO Com' ,3 Fax:,--,g E-Mail: Phone No 336 b -"� Fill in fee simple Title Holder on next page(if different E-Mail:- KI 4 U����� A C"?ry-1 from the Owner listed above) State or County License: nL 7 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION lg-N LAWIiNF®RI�/LAl'ION: 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: 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 osted on the jobsite before the first inspection. If you intend to obtain financing,consult with lender ol attorney before comme)WiqR work or rejording your Notice of Commencement. s _Signature of Owner/Lessee/Agent Signa ure of Contractor/License Holde STATE OF FLORIQA STATE OF FLORIDA � , COUNTY OFS` COUNTY OF 51 Z— VG The forgoing instr ent wa acknowledged before me The forgoing instru ent wasacknowledged before me this e day 20 LS�y this day of 204L by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Public-State of Florida) (Signature of Notary Public- tae of Florida) all own�_OR Produced Identification P �bnallKno OR Produced Identification Type dentificatioLn/Prroduced Typ . tion Produced li Commission No.0 I r �2`� (Seal) Commission No. (Seal) a' K AM KATZ KIRK All `, ta11'< t�MNil66'ON 44924 Revised 07/15/2 'l COMMISS ON #FF044924 �•.. �,A EXPIfiEt�,Allttl 12.2017 EX�•IRi_::Awq ;t 12.2017 ,E?f„R '`' :uw'au,com (407)34ftSd;1.5 i a� REVIEWS F PLANS VEG TATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS