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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �� V! Permit Number: „T I • 0 sat RECEIVE � q � DEC 112015 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 Y� PERMIT APPLICATION FOR: '�N C �- PROPOSED IMPROVEMENT LOCATIC'N.. Address: 4`11-9 119eacA 47Vet-rL e, Oporf Sf 4Ltcic, rL 34.9S 2 Legal Description:_ i Ver Farb' Urfa- 3- ib/k S l o-� S (dAg 3!*a7- � (©JC3 12s=Z Property Tax ID#: 941q- 515- 0032­ 000 - 90 Lot No. Site Plan Name: Block No. Project Name: dz1 vele Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK z' eel a ol To fi CONSTRUCTION INFORMAXI ON , . Additionalwork to b e performed un lert is permit-check _all.that apply: _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: $ go O 0 Utilities: —Sewer —Septic Building Height: 01NNERILESSE .. CONI"RACTOR fi 3 Fc Name Aa 4e.!lt a /���,lli.f cS Name: Address: 0/9 ez r-k A &ti Company: City: orf sf L[. Cif, Stater Address: Zip Code:94 4?5- Z• Fax: City: State: Phone No.7/72 L 2 4 9 112— Zip Code: Fax: E-Mail: 0 2 e► Phone No 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. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFQRMATION �E... ,.w„ ..., 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 stfucture which is in conflict•with.any applicablenHome Owners Association,rules, bylaws or and.covenants that may restrict or pr`o'hibit such structure. Please consult with your Home Owers.Association and review your deed for'any restrictions which may a'ppiy: <Iri consideration of the granting-ofthis,requested permit, I do hereby agree that;fwill,in all.resp:ects, perform,tV'&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'npri 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 o.n.the jobsite before the first inspection. If you intend to obtain financing, consult with lender-or-an attoMbOb"efore commencing work or recording our Notice of Commencement. Signature o N_wner/lLes a/Agent Signature of Contractor/License Holder 4. STATE OF FLORIDA - jby _-- .i Uj STATE OF FLORIDA COUNTY OF `° = COUNTY OF a � a The forgoing instr ent was acknowledged bZ.Z.w z The forgoing instrument was acknowledged before me this day of 20 f,�^ �� this day of 20_ by UX v orh,e �)iGl &L I it (Name of person acknowledng) a (Name of person acknowledging) .. (Signature of Nota Public-State of Flori a) (Signature of Notary Public-State of.Florida) Personal) n OR Produced identification Personally Known OR Produced Identification Type of I entifica.'o Type of Identification Produced /Y ' C Produced Commission No. (Seal) Commission.No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION,- SEA TURTLEy 'MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW . REVIEW ; ,• PREVIEW DATE ,. RECEIVED DATE COMPLETED Te—v.7/2014