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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE I FO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: '' Permit Number: J Building Permit Application Planning and Development Services Building and Code Regulation Division / 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential i PERMIT APPLICATION FOR: r�PTx r :' ¢.u ..ar.a.'�'.,s ,�' vim -^ a 1 `C{' .�a - a_ =r IAnmsED_ IN"P1R®VEMENT LOCATION a� ;, ri � �m r jPn. �� � r_,P h 4- �� "a � . t.�_ w Address:_ko q 1�.5� �.. Legal Description: ��.,s. o,1, C' ©%.D.}- C �C)Ia 91Q adkm I0. �- Property Tax ID#: Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: I-—IN-41 DETALLED DES'CRIPTI,ON F WORKS ` N®r, ' n p o VM ` CQNSRIJCTION. ®RMATI®IV tir x. Additionalwork to be performed 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: Cost of Construction: $ Utilities: —Sewer _Septic Building Height: OUI/NESSEE � CON!TRACTQR: Name ne Ll,r,n ' an.�.y, Name: Address:_ tey:jQ ,�V,rN4. y .S . -. Company: City:V-a,ck T',',e.�r State�� Address: W, K3,j_-J, -546—. 61. Zip Code: Fax: City: Tme-14 VEIRM t. State:__r-_i. Phone No. l 5LB rorj n Zip Code: SZ9 q P— Fax: E-Mail: Phone NO-)Z`�` 3- °L 9 `17 Fill in fee simple Title Holder on next page( if different E-Maild ,,,, �o from the Owner listed above) State or County License -9- If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. S11�PPLEI�/IEIVAL C®NS�TRl1�TION LIEN LAU1! IN� O�R+M�►TI(JN: 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 Imill, 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, cor pNIt with lender or an attorney before comrrAcing work oplecording your Notice of Commencemeyrt. Signature of Ow r/Lessee/Contracto ,as Ageot for Owner gnature of,Contrac /License Holder _ STATE OF FLORIDA STATE_OF FLORIDA , COUNTY OF �� � COUNTY OF t. -Theformoing instrume wledgVAbefore me The forgoing instr ment was acknowled ed before me th' -�S?day of 20 by this l day of 2V� by (Name of person acknowledging) (Name of person acknowledging) (Signature of Notary Pu c-State of Florida) (Signature of No `ic-State of Florida) Personally,K` u d Identification Personally Known .�o� :roduce t'r n Type of Idenfi),'����"'� G LA M HUFF Type of Identificatio =�« otary p�GELA M HUFF N tar P Produced htic_State oIF Produce _� f Florida of loO y comm, !on#FFP3q�°rlda n _ ommissiori#FF 234730 ""'""'' -9, E / 3o Commis n fSc�gF;a' My Comm.Expires May Ov-abh9 Commission No._ 9ondedthropgj� I �O az7 2019 NationalNotaryAssn nal YAssn c� REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW ` REVIEW REVIEW REVIEW REVIEW REVIEW DATE \ RECEIVED, DATE COMPLETED ev.