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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED a Date: Permit Number: RECEhVEED - � - - - Building Permit Application MAR 11 2016 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 7)(� PERMIT APPLICATION FOR: PROPOSED I!NP'@V1/E ENT LOCATION: Address: 750-7 1gkc,;Je GIR;:P UJ44 Legal Description: PropertyTax ID#: 1301 lava - d00L1 (Do Lot No. Site Plan Name: t Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DE�SC�RIPTION OF WORK: .f . CONSTRUCTION INFORM TION: itiona wor to e pe orme _ under this permit-check all that appy: _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:$ Utilities: —Sewer _Septic Building Height: OW; ER1/LE�.StiSEE: @ONl"RAG `®R: 1 Name/2x :►M. �i >YVi�� Name:,��t., C)Sc.�rl�`.�.� Address: 75 7 1.oi,�eS���e Company: ,,.4',,, Cn,�6 cloy. City: pqr+ P`'rce- State: Address: p0 goy IoSc)gc,T- Zip Code: 95-/ Fax: City: yems SQ,,-A State: Phone No. 7V-c= 7q Zip Code: 3901(oS Fax: 7791-18 .S6S0 E-Mail: to QO\. r- wv-\ Phone No Fill in fee simple Title Hol er on next page(if different E-Mail from the Owner listed above) State or County License C G G I S I roq q'�L if value of construction is 2500 or more,a RECORDED Notice of Commencement is required. StJ�PPLEMENTAL C©N'STRUCTION L �N SAW IN?�ORMAT(ON: 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 t " bae before the first inspection. If you intend to obtain financing, consult with lender or an attorney b fordr ; comme work or recording our Notice of Commencement. d ; - a� m N 5�:m it Signature of Owner/Lessee/Agent W do v Signature of Contractor/License Holder 11- STATE OF FLORIDA STATE OF FLORIDA COUNTY OF m U5M z COUNTY OF The for oing instrument was acknowledge b �e0% The forgoing instrument was acknowledge be :0. this day of/! - !�—: �"' this�day of 20 `' ;«,; (Name of person acknowledging (Name of person.acknowledging) Oil (Signature of Nota/ublic-State of Florid ) (Signature of Not y Public- tate of F orida) Personally Knowre OR Produced Identification Personally n /R Produced Identification Type of Identification Type of Identification Produced Produced Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED :Iev.7/2014