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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICAB E I F TBE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: • 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 PROPOSED IMPROVEMENT LOCATION: Address: 7 © W P_ Legal Description: Property Tax ID#: l 3a?_&v r oo73 "x)0!9 Lot No. �2 Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: f i�cepi w,- o� 4-0�Q I d ec-Fere (va+_k h ea e P Zig- XP- fire CONSTRUCTION]NFORMATION: Additional work to be nertormed under this permit—checka appy: OHVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors 11 Electric ©Plumbing Sprinklers FIGenerator Roof Total Sq.Ft of Construction: SFt.of First Floor: Cost of Construction:$ 600 Utilities:i Sewer 0 Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name Address: O Company: G City: T�?1-4 Pierce State: F Address: o Zip Code: Fax: City: n t State: Phone No. 772 — y8 — 405 Zip Code: 9 Fax: E-Mail: Phone No. WOc_ 07— 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 INFORMATION: 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 Count 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 comme work or recording our Notice of Commencement. s _Signatuof Owner/Lesse Agent Signature of C /License Holder IP6 STATE OF FLORIDA , STATE OF FLORIDA COUNTY OF J� 6,c-e ew z COUNTY OF �� &,e,:�e The for oing instrument was acknowledged Pefore me The forgoing instrument was acknowledged before me this. day of D.3 2o/oby this !/ day of 1:�� ,20/A by sj�? lel �- °Y 11 1k,i S40P�C�1 h (Name of Ofson acknowledging (Name of person acknowledging)' �. (Signatur f No P "ic- tate of Florida) (Signature Notaryub• -Stat of,Florida) Personally Known rsonally Known n Type of Identification Pro ice pe of Identificat n�yrod}�G e KIVELY OPIYO ®� Notary Public,State of Florid c °� Notary Pu Public, a e o on a Commission No. " (S mission#FF 167526 mmission No. commisgWgf 167526 My comm.expires Oct 9,201 My comm.expires Oct.9,2018 Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS