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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED r j 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 10: v y a � ^*S✓"" j '; %'.�}:+a. PR r°POS' IMPRR®VEIVIEITLOCA 5` � � Mk� h �x WN Address: Legal Description: 7 Q Property Tax ID#: .tel' d� j! — Lot No. / Site Plan Name: Block No. _ �/� Project Name: �k Setbacks Front Back: Right Side: Left Side: i >. f ' DETA1LEp +a D CRIPTION OF�WU6 K IVU-s�..,',';.,.?xn 3�n#a�.�,�.f .a< +A' k..z cam I Q.o ate' G__ view r tri96/ A ,'`Ri`4�?,„Py#D:+t' a yx} z �' #"7 a', ECON5TRUCT 0 IN.'`ORIUI-ATION Xj � � ,�q 4-7::�`.,.., •-�m,....��.���3'�: z '"r;.a?:;4_Ra"d�` 3;:�'.xw .. &t.. ��aY_:�'Eke }... Additional wor to nGasTank orme un er t is permit-c ec a appy: ❑HVAC'. ❑Gas Pipin _Shutters l Windows/Doors'g # 11 Elect ric OPlumbing Sprinklers 11GeneratorI.�Roof Total Sq. Ft of Construction. A S .Ft.of First Floor: C3 C)Cost of Construction:$ �. D� Utilities:]Sewer Septic Building.Height: y fi�7'.��,'" E'� r +a I= m "�', -•.§ �:4�'._ r: , �OWNER��°°LESS- Ex �, 3 . .==ie� 'a' `:"•!'&. iiS�'sti'wt$dr�. .,+evr. r',...:...;. �3a-a r11*. z'. =Y�� o :..F''• -,F•a Name 7 000$fJna Name, . Address. Company: City: A State. Addre Zip C e: (q S`_] Fax: City: 2� State. Phone No.q119 9 �f'i- 1Zip Code: �1c�2��i x2-��3"'��`r] E-Mail: Phone No.-) 3-1 56 S Fill in fee simple Title Holder on next page(if different E-Mail: ( m from the Owner listed above) State or County License. If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: a 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: 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 Notic f Commencement may result you�ed mg twice for improvements to your property.A Notice of C encement must be recorded and on the jobsite before the first inspection. If you intend tain financing,consult with I attorney before commencing work or reMrding yoypWtic of Commencement. i s _Signatur of esse /Ag Signature of icense HoldeL STATE OF FLOR STATE OF FLORI COUNTY OF COUNTY OFA i The Ing Inst m nt was act �owledg before me The f rgoing instr ent was a 1<nowledg d before me this,v of O��by thi�y of 20 by 04 (Nam per acknowledging) (N of p son a nowledging) I ( Ignature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Personally KnownOR Produced Identification Personally Known OR Produced Identification Type of Identificati Producedype of Identifica on Produced Commission No. ,,,���� (SeQREISS SCHWAB ommission No. "� eSHREISS SCHWAB Notary Public-State of Florid �� , �+ 427 :�sPtiv P�A�''% r-State of Florida 2019 a ° + ,' Revised 07/15/2014 '}"'� Q' Comm.Exp►res Mar 3. (I Commission# FF 2054212019 , °��,°�f���`._. _ -` ,� ',�y� e,� Comm.ExplreS Mar 3, REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE i INITIALS