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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:�T/ Permit Number: A, `^ Building Permit Application RECEIVED Planning and Development Services FEB e 4 2016 Building and Code Regulation Division / 2300 Virginia Avenue,Fort Pierce FL 34982 V/ Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPQSED IMPRMUEMy,EIRS T LOCATION: Address: Legal Description: V3L1y__ 1 MSP S Property Tax ID#: ©Zo°7 00 0_ Lot No. Site Plan Name: \ Block No. 2- Project Name: Setbacks Front Back: Right Side: Left Side: ., ID;EaT�A.rI,LrEDID�E�SCRIP�TI,�,N O'WARW F�W.O;R�K: CO STRUCTlO JCNlFfflMATION: Additional work to be nertormed under this permit-check all appy: HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors Electric ❑_Plumbing Sprinklers Generator _Roof Total Sq. Ft of Construction: 3-210 0; S . Ft.of First Floor: Cost of Construction:$ 1 k S'1 Utilities:1n Sewer Septic Building Height: . OWNER/LESSEE: CONTRACTOR: Name_ N�C�?i��n �g5 Name: Q'rs .O Address: C Company: CitState:`fti Address: Zip Code: Fax: City: State:-4F Phone No. 1 'L� Zip Code: r3>Zfl (O Z Fax: 16x6-�k(d2�( E-Mail: Phone No. Fill in fee simple Title Holder on next page(if different E-Mail: 6(50q 'k from the Owner listed above) State or County License- 3�3 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. EVPPl1EI ENI'IAL CONSI'RU�TIO'N L('�, [N#j®ftl\/IATI®N: DESIGNER/ENGINEER: of Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: L-11_Not Applicable BONDING COMPANY: _ of 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 thepermit 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 or recording our Notice of Commencement. s _Signature o ner/Lessee/Ageontractor/Licens older STATE OF FLORIDA STATE OF FLORIDA COUNTY OF i N rey QT COUNTY OF —K7 The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of 20 by this day of 20 I by (Name of person acknowl ging) (Name of person ackno ]edging) (Sig&eure of Notary P/ic-State of Florida) (Signature ofotary,Public-State of Florida) Personally Known V OR Produced Identification Person II K wn --�OR Produced Identification Type of Identification Produced ISAAC. P R o en 'fication Produced Commission No. ° . : Notary Public-State of Florida L�_�g f ;•. n•=My Comm.Expl ofigrTgni �B 0._j b l7 (Seal) = OF Commission#FF 086006 •�lF of F Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS