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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /� t Date: �l �- ��0 Permit Number: V J is I �7 E.11VE - - Building Permit Application AQP ` `' 20% PcR:&iTrING Planning and Development Services ;;. Lucie county, FL 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' lGL PROPOSED INePROVE° EN M{ T LOCATN 'N; Address: & 3 TZ-- Legal Description: f 0071igtJ ?l VF- tl,,�)r67- f-3Lk 6-1,—3,:::, Lm V-\ 3 4-A Z�' � D n- �Z2 - 154 — 1250 Property Tax ID#: 34a 2 �P D `/' i" Lot No. Site Plan Name: n Block No. Project Name: 1G(Jr2jill Setbacks Front Back: Right Side: Left Side: DETAILED D.E�SCR�IPTI® 11,91` 1IVQRfK l d K U P — G(j�Q—Jjex� CeTY C®NSTR�l�CT1Q I�N�F®RBM ► !®N: Additional work to be pertormed under this permit-criecFall t ata,pp y- _Mechanical _Gas Tank —Gas Piping Shutters _Windows/Doors Electric _Plumbing _Sprinklers _.Generator _Roof Total Sq. Ft of Construction: e) Sq.Tt. of First Floor: Cost of Construction: $ Utilities: _Sewer" _Septic Building Height: QUUN�ER/SES : L C.QNTRA CTQ Name Co !-e P Name: Address: (a ©l3 t)C c T) Company: City: Er -P (EP-c- F-=:- State:FL, Address: Zip Code:,3�-{-(��- Fax: City: State: Phone No. 772 G IF-3 Zip Code: Fax: E-Mail: Phone No 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. 1 Sl1PPlEME�NTAI.CONS�TRtJ�TtaN Lli�N LAUV IN'FOR+MATtO�f: ' 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 the jobsite before the first inspection. If you intend to obtain-financing, consult with lender or an attorney before commencing work or recording our Notice of Commencement. Signature of Owner/L@9CeeLCQjat4actor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORI la^ No, STATE OF FLORIDA COUNTY OF ,� o' ' = COUNTY OF The fo oing instr ent was acknowledg d bef e fi1L'" The forgoing instrument was acknowledged before me thi day of ,20�I b this day of . 20_ by vp c M, m is NN< cn m Na a of person acknowledgingT (Name of person acknowledging) C�N n d O� .P fD N (Signature of ary Public-State of• orida (Signature of Notary Public-State of Florida ) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Incl ifi ation Type of Identification Produce / { Produced Commissio 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 Rev.