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HomeMy WebLinkAboutBuilding Permit Application i All APPLICABLt INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: O/ "a Permit Number: I II REGI° Building Permit Applicatio SPR 2 5 2016 Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)11462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: I w:. Address: ) I ��•�y �� Legal Description: Property Tax IiD#: y U a ^.1607^01-6 ^ �7- Lot No. Site Plan Narre: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: /-/Co I t�� 75- c"" 14-e� I Additional V10 rk to be pertormed under this permit-Check all ME app y: —Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Electric Plumbing _Sprinklers _Generator _Roof Total Sq. Ft if Construction: Sq. Ft.of First Floor: Cost of Construction: $ 0, Utilities: —Sewer _Septic Building Height: Sf Name # C- Name: Address-,(I5/!K(-(/-z,/- ©0 6 I)r Company: City: car r- P,P�GC- State: L Address: Zip Code: Fax: City: State: Phone No.l 7, ��a�6-dl Zip Code: Fax: E-Mail: 79A- is Phone No Fill in fee iimple Title Holder on next page(if different E-Mail from the Owner listed above) State or County License I If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. I i MEN= 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 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 financi , �t with lender or an attorney before comme c Rg work or recording our Notice of Co ncement. Sign u of Owner e/ ractor as Agent for Owner nature of Contractor/License Holder TE OF O A STATE OF FLORIDA COUNT COUNTY OF The f rgoing instr ent was acknowledged be The forgoing instrument was acknowledged before me thisday of L, 20A b L a this day of ,20_ by LLJ r (Name of person ackno ledging (Name of person acknowledging) co ````*•ro CX-- (Signature (Signature of N ". ry Public-State of Florida) ',;;;fit' , (Signature of Notary Public-State of Florida) Personally Know OR Produced Identification Personally Known OR Produced Identification Type of Identi icati•n � r Type of Identification Produced Uig - 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 Re—v.7/2014