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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: --.26 —1 Permit Number: Building Permit Application MAY 2. 6 20% Planning and Development Services PERi11ITTiRIG Building and Code Regulation Division St. Lucie County, FL 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: f,C �I cAL✓ I?NROPOSED I1V'PRQVEMENT C# Address: Address: �/�� S. 0CeAlN Y2 ' AFL 3y -?J-'7 y. 1, Legal Description: �,�.v ,�- (S Property Tax ID#: 02.- ( Q !- l J 1,2. ©l J 0 Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: 3 DETAILED DESCRIPTION OF 1IIJOR ; , � 4 RKEk -6io ' ol./. C , (/- l(c�ioC'ygze scC)r�M'..�5 W KI CONSTRUCTION INFOR'IUTATION y y n a4 Additional worK to be pe orme un er t is permit-ctlecK 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: Cost of Construction:$ Utilities: —Sewer _Septic Building Height: Q;WNER/LESSEECONTRACTOR _ � . Name e92 -e-- _R'ro-Px Ap-v Name: f?Aee 'V f�/iyerd�a Address: 5 T o C. It r� J Dom. Company: (�.L, L,P iI (��veitL_ I CC City: ,�� r i,a.,TA- (3©Cl- State: T Address: S. eckv-,4-1 VLl ML►R 40 Zip Code: 3U l?5 7 Fax: City: PP,S.(_ State: Phone No. Obi KW0)U 1 J Zip Code: .34qd.2. Fax: E-Mail: Phone No 77z- I✓,_Z Fill in fee simple Title Holder on next page(if different E-Mail ,CW' c,.:) 1 oc.4 from the Owner listed above) State or County License _2of2902 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN IU1/ INFORMATION 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 financing, consult with lender or an attorney before commencing work or recording our Notice of Commencement. S Sigrvgrure of Owner/Les Agent Signa of Contractor/ ' Holder STATE OF FLORIDA 11 STATE OF FLORIDA COUNTY OF , \. I�,IF. COUNTY OF °A LL.uelL The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me thiso'�G day of }��_,20_ by this day of Vl(lAq ,204 by C ye,Iek (Name of pets n acknowledging) (Name of person acknowledgi ) (Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification 1/ Personally Known OR Produced Identification ✓ Type of Identification Type of Identif' tion Produced _ _ o u ed - KAIIIN NICLS . I<AlZ�N S. NIE SEN ;q � S. - N Commission No. k Commission N FF 11�m Sion No. °=(S �4�mission #FF el) '.Fo4.�° y Comr on 115 3 ;yea My Commission E pires nissi 9.. °:``P June 12, 20 8 =--June 12. Epi,., REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.