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HomeMy WebLinkAboutBuilding Permit Application All APPLICABL INF MMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED t� Date: j I Permit Number: I� J w Building Permit Application MAY ?a� Planning and Development Services Building and Code Regulation Division PERMHTTINGSi. Luci C ur;�; i!_ 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: ROPOSED {NPRQUEMr,IENT LOCAT)tJN: Address: 1 Coquia.4Av8 r ��e 610 F)- 3 A 9S'i Legal Description: Property Tax ID#: I b\ o it) 1 00®^ Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back:_ �t Right Side: Left Side: r"R.TAILED DEQ-YCRIPTIO A,'=RK:` b S ro xr r % s 6 W ANS c ' � S�r---b i-r5 ®n1 Co" e/�-�`T� j3 Lo cKS USII J ei l r FDS S =10—&A G�� } f��5 T ldJr,�lbdcx�S �(ZoIC, �wN Ao CQNSTRL)CTQN INF®RMATION: Additional work to be pertormed 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: /2 ` O1 Cost of Construction: $ �. Utilities: —Sewer _Septic Building Height: OWNAERJLE�SE C©NTRACT®R: Name GO l AlR'�JL� Na � Address: el Aj A Company. City: Stater Address: A 2.i-q Zip Code: Fax: City: t P �6,t, c-�< State: Phone No. r7 q 2 - H T7'3 - -3,32 Zip Code: -3`As 1 x: E-Mail: SC��"7' CR�r -G(1'Z3®_� o hone No � -?& Fill in fee simple Title Holder on next page(if different E-Mail �417'r4k from the Owner listed above) Stat ounty License If value of construction is 2500 or more,a RECORDED Notice o ommencement is required. LUV"F 16 EMTA ENT L CSN TRUCTION LIEN LAW hNO'RIUI TI0'N: 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 oUecording your Notice of Commencement. Signa ure of Owner/Lessee/Agent Signature of Contractor/License Holder STATE OF FLORI A STATE OF FLORIDA . COUNTY OF ' _ C,� COUNTY OF The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me this] day of 20L(..e by this day of 20_ by (Name of person acknowledging) (Name of person acknowledging) C v (Signature of No ry ublic-State of Florida ) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification✓/ Personally Known OR Produced Identification Type of Identif ation Type of Identification Produced educ, ,,•Fara�e, KAREN S. NIELSEN Commission No. I = _ Commission# rCdrffifi ii si No. (Seal) 9 f oma, My Comm i Expires "'%�°F« June 12, 2018 REVIEWS FRONT ZONING . ,, SUPERVISOR PLANS VEGETATION SEA TURTLE - MANGROVE COUNTER REVIEW' . REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.7/203.4