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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 1 1a, 4aa O REM`L piii ` U BuirCIV�D DEC 14015 ing 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: RflPOSED IP�CIVEMEU, wL��AT > �, !, , ...\\ Address: 9 / � 1� v2 - Legal Description: l U Property Tax ID#: 1 a" $�a ' 43 all C306 -4;�) Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: r *'�rc,'�a _ k� •_sfifi^ 1 ,.9i; ua .. kms'^' # a�i' � :`^ ; - r + 15y CC ' tSTFtl1C{TI, 1N 1N` F4RNATfONa.;��r gn �w MOO r 1 . terE i„^! >za h �, "k�,n�WY,.r Additional work to be performed under this permit-Check all that appy: _Mechanical =Gas Tank _Gas Piping _Shutters --Windows/Doors Electric P ul mbing _Sprinklers _Generator _Roof Total Sq. Ft of Construction:. Sq. Ft.of First Floor: Cost of Construction: $ /�9D© Utilities: _Sewer _Septic Building Height: yrx ig :.,=te : E �" Ng- 'z a �...s +.` `7r O : NRILESS E Name 0.4 fZ P, 2 �� ,�iiri�rs'L— Name: sai Address: fj 2-1:1? t7 /, ,,,) i3F,cJb L.g,jzz- Company: City: Staters Address: P C 3 o x' 1307- A9427- Zip Code: Fax: City: E0 tl(- e-Com- State/EG Phone No. '?/719 Zip Code: Fax:- E-Mail: Phone No 772- 0 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. a w LANA cto]Nsiluc- �oNw r .,oRir 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: 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 commencirt wor or r Eord' our Notice of Commencement. Signature of Owner/Lose '%Co ractor as Agent for Owner Signalure of•Contract /Lice a Holder. STATE OF FLORIDA STATE OF FLORIDA COUNTY OF • LUc�� COUNTY OF S�• LOc�Q The forgoing instrument was acknowledged before me The forgoing instru ent was acknowledg before me this�V1 day of ��C 20% by this�day of �eC. 2b6 by o \ s A-2 as A-( � (Name of person acknowl dging) (Name of person acknowl dging) :al (Signature of Notary PublidUtate of Florida (Signature of Notary Pub ic-State of Florida ) 2 Personal) Known OR Produced-I Personally Known OR Pro V�r�tfi@��i�� G,6 '� y tfi@i§�,F�°��aa Type of IdentificationacyeJ�\EXQ�ces��ay816 PSS So r- Type of Identification y� `Ge°bC�°"\Sesoe° Produced o� °# �yo�ay Produced �a y Exp Ee ss° E•. GGNa��ooa�N°, �����. Commission No. - ded a Commission No. L �* REVIEWS FRO ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 7/2014