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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED AQ0('Q Date: Permit Number: i 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 V ' I PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line IMPRCIUEMEa�1�1.00AT1� Yi r ...un�.. `Address: 'R a K I and 5 ) kid .te EL 3 el i Legal Description: i o-r:5 ilo,t-1J' arNd +�'r_ Wes-' '/2, C) t- 1-0 lea 8IC)ek ,40RiyerA-02 yaC4 C.lvb Property Tax ID#: J7�lQq - ®rJ ' ©C)So' 0o a/� Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side:l- c©nn ec-V +© w ak-e.Y- w-el-esr. ;i .. .._ r- >Additional work to be nerrormed un er t is permit-check all appy: ❑ I � HVAC _Gras Tank Gas Piping _Shutters Windows/Doors E 11 Electric L_`�Plumbing Sprinklers ElGenerator I E Roof „i Total Sq. Ft of Construction: S . Ft.of First Floor: Cost of Construction:$ Utilities. —Sewer[]Septic -building Height: � NC� " >. E=R/Iwl 5S -a� ,. Nameg161a14 Jo8,i A, Garavker Name: `f0634 K b6-C9-SVI.., Address:120(k' PSrI lar%d k)14 Company: i W I PL-C- ;!J< I�l.t�ye�f3i_/Vf?' City: �=-1 . fDle,rc e__ State: [--L— Address:+43'1 1?l !p`-CA!ri&L A c Zip Code: ?q9 SoL Fax: City: r 7 Pier - 'L-15 State: FL_ Phone No.712 - q&1 -oI A l g, Zip Code: S q clW-2 ;'� Fax: E-Mail:r leonard aardner P_ bel1cu;-C.net Phone No. q&) Fill in fee simple Title Holder on next page(if different E-Mail: from the Owner listed above) State or County License: i If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. i ii 'i ' I i ' 3� LIVa? IY1 �13 DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: W C—L-5 Address: Address: C) 3G ;90 City: State: City: (=` AE(EN S B62ti State: �1 Zip: Phone: Zip Phone: StK,- Sl 72- 3202/ FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: I Zip: Phone: Zip: Phone: I I certify that no work or installation has commenced prior to the issuance of a permit. I 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. I 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 _Signature of Owner/Lessee/Agent Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instr ent was acknowledged before me The forgoing instrument was acknowledged before me this day of 20 L by this_day of 20 _by r ( me of erson acknowledging) (Name of person ackn wledging I) i 'I ( igna ure of Notary Public-Stab of Florida) \ (Signature of Notary Public-State of Florida) Personally Known OR Produced Identificationy Personally Known I OR Produced Identification Type of Identification Produced Type of Identification Produced c C4 5�,, C-ommission No. ,,,CRY" �1HNA IN6RAM Commission No. (Seal) `o�P B%''• Notary Public•State of Florida. :2♦ a�'= ; .= Comm:Expires Dec 20,2016 Commission#F Revised 07/15/20 ,° '� 9 h Nat .4 Bonded lhrou ional Notary Assn. i .. I REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION !SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS I I I i I