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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: —�U Permit Number: sem. -- .� RECER"—_D JAN 28 2016 , 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 1Y\O PRQI'©SEIJ IMPR©U1E/M/ ENl' L>OCA/TIQ-N--: Address: 5// l 77/,'5 /J7/UC/ j7eofii pe�cc4 /q. 3119'57 Legal Description: ly�_IleJ e�'Q15- Property Tax ID#: Y5_02_ 5701` 0'116'7- 000 1 Lot No. .3/ Site Plan Name: 1141#115 Block No. Project Name: .3,f Setbacks Front Back: Right Side: Left Side: DL- tLED DESS R+iP 0 OAF W4-911 MMA2.16-400I '11111111 J 1111 WWW ®RiC. a C01�1�)e IC dem o1,1VP 01W zi J, tC94, '�P) 4pie CONSTRUCTL©.N I.NFORMAT(ON: Aaditional work to be ertormed under this permit-check all appy: HVAC Gas Tank Gas Piping. _Shutters Windows/Doors Electric ❑ Plumbing .. 0Sprinklers Generator Roof Total Sq. Ft of Construction: 7 Sq. Ft. of First Floor: d7 Z Cost of Construction:$ /700,tic Utilities:ZSewer 0 Septic Building Height: 9 OVIINER/LESSEE: C®NTRACTUR: Name7'= - Name: q fd, Address: /0,0 'at- /7 Company: .cryn Sym f�a�ctif fvc_ ;LJc City: 8,w A-e_14IIIIIIIState:j261 Address: Zip Code: ggy0 3 Fax: City:Tiro Se,7 9e.,,ch State:10I Phone No. 7,2 q" Zip Code: 3`!`7T7 Fax: -,1-32- -219/ E-Mail: Phone No. -772- U0 -37/6' Fill in fee simple Title Holder on next page(if different E-Mail: -C y!i/tea-C 'nvm from the Owner listed above) State or County License: CdC 1.2 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. Sl1PPl EIVIENTfi►L CONSTR(JCTON 011 LAU1/ INFC0001MAP►TI®N I''iiiDESIGNER/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 posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work.orrecording yourjZtice of Commencement. s _Signa ure of Owner/Lessee/Agent Signatu of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF 5''c L Q<A-1 COUNTY OF 5-F, Lyc%� The for oing instrument was acknowledged before me The for oing instrument was acknowledged before me thisa" day of Jam 20C by this��day of20 06 by �c�gv IfS yN CSXA V%. (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary blic-State of Florida) S i�aa (Signature of Notary ublic-State of Florida) JFK Flo �6 o S Personally Known OR Produce Sill 1pro' Personally Known OR Produce ti Type of Identification Produced ° she 5� ,,PSS.i Type of Identification Produced spa �6�• cue ��Q�� a��ir` � �a�`1 P� XP`�es SSSS P55°• Commission No. Seto °�a � k `° X0`0 Commission No. a `yP -\A�� c°mcm�°U9hya��o aC • a I.t - m o. dt Revised 07/15/2014''- REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS 74titliu II' o Fr Plannl'ng�Develcpmenservices ASBESTOS NOTICE Building&,Code Reguk6n Division 2300 virglnia Avenue; ;Fort Pierce,FL 34982 _ Phone(772)462 2172',Eax(772)462 6A43 Asbestos Notice to Contractor January 28, 2016 ADAM SMITH BOBCAT SERVICE INC IL E copy ADAM SMITH 661 NE SPENCER ST JENSEN BEACH, FL 34957 RE: Building Permit Number 1601-0418 Itis your responsibility to comply with the provisions of Section 469.003, Florida Statutes and to notify the Department of Environmental Protection of any intentions to remove asbestos when applicable in accordance with state and federal law. Signature 161 Date 1/28/2016 2:18:53 PM