HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:'
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uiidin Permit Application
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Planning and Development Services
Building and Code Regulation Division ! 1
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2300 Virginia Avenue, Fort Pierce FL 34982
Commercial
Phone: (772)462-1553 Fax: (772) 462-1578 E I Residential
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PERMIT APPLICATION FOR:
Address: ���- _
Legal Description: 6 �/.� `i �� 1 � � ��� l�i�
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Property Tax ID#: Lot Na.
Site Plan Name: Block No.
Project Name: o!5
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Setbacks Front Back: light;Side: Left Side:
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Additional work to be performed un er t is pegmit-Icheck all that appy: I
_Mechanical _Gas Tank has Piping Shutters Windows/Doors
_Electric _Plumbing ��Sprinkiers Generator Roof
Total Sq. Ft of Construction: i Sq. Ft.of First Floor:
Cost of Construction:$ 49-71 ° 0 Utilities —Sewer _Septic i Building Height:
Name k7c SS v Name: eY CLA-0
Address: 67-0-2- Company: JD Wv-e r � . awe LI- e
City: � t State: " Address: 0 I Qt 2)
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Zip Code: �j c{cl Fax: � _ City: �✓ GLYt State: '--
�o 4 al ' t 3� ~ y ?� Zi Code: 121,-79"
Phone No. ;— p Fray:
E-Mail: Phone No. 4G7>?: -
Fill in fee simple Title Holder on next page ( if clTerent E-Mail: I�
from the Owner listed above) { State License: 1�r? C lS o
if value of construction is 2500 or more,a RECORDED:Notice of Commencement is Aecluired.
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SUPPLEMENTALCONSTRUC°fION LIEN L. W INFORMATION:
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DESIGNER ENGINEER: I __ Not Ap licalble MORTGAGE COMPANY: Not Applicable
Name: Name: —
Address: Address:
City: State`. City: State:
Zip: Phone: I Zip: Phone:
FEE SIMPLE TITLE HOLDER: 11 _ Not Ap hcable BONDING COMPANY: Not Applicable
Name: Name:
Address: -� Address:
City: City:
Zip: Phone: Zip:_ Phone:
I certify that no work or instailatiorfi has commenceld prior to the,issuance of a permit.
St. Lucie County makes no representation that is gr ntinga permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owne s AssoclatIon rules,bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your dome Owners socia'tion and review your deed for any restrictions which may apply.
In consideration of the granting of this requested p rmit,'I do hereby agree that I will,in all respect perform the work
in accordance with the approved plans, the Florida uiiding Codes and St. Lucie County Amendm t
The following building perm' plications are exempt from undergoing a full concurrency revie : r m additions,
accessory structures,swi in polls, fen es,walls signs;screen.rooms and accessory uses t ono er non-residential use
WARNING TO OW/NR: Y ur fai re t Reco d a Notice of Commencement may r suit' your paying twice for
improvements to r pr per A N tit
c f Cornmencpment must be rec r ed a d post n the jobsite
before the first intio . I yiou it nd to blain financing, consult with Ycler o an a orny before
commencing worrec dint ou Natic of Commencement.
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Signature of Own /Agent/Lessee Signature of Contr for/License Holder
STATE OF FL IDA STATE OF FLO DA
COUNTY OF ANGE COUNTY OFOR 1GE
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The f tng i stru nt was ckno�ledge fore e :The f r� g gins 1 nt was acknowledge ore me
this qday f�,��' 26� h} ;this day 20 by
PETER ACAFARb iii i !PETER A CAFARO ill
(Name of person acknowl (Name of person acknowle ing}
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( ignature Of Notary Public-State of f arida} (Si nature o Notary Public State f Fior da }
Personally Known x OR Produced IdentificatiiPn Personally Known x OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. EE 174164 mmission No. EE 174164 '11Pr Nor r tcSiaieofFtonda
-P Ptd ` Notary�Swe z Kari M Riccaboni
Kan M RiC bonip G ' rA Commission E 1741-4
rAy
j ' or w° Expires 0512 2016 °r °�.r. xpir�e `Rt3t20 Vo
Revised 07115/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW *VIEW . REVIEW REVIEW REVIEW REVIEW
DATE i
COMPLETE
INITIALS
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