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HomeMy WebLinkAboutBuilding Permit Application All APPLICABL INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 9' 1• � Co Permit Number: 0440 .• ► RECEIVED - Building Permit.Application- Planning and DIevelopment Services JUN Z 1 2016 Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)1 62-1553 Fax: (772)462-1578 Commercial Residential PERMIT A(PLICATION FOR. PRt�P`QSE�Dt�#��1�C111E �. Address: �0 Legal Description: U(t1\I _ t; OCA -Property Tax ID#: l 30 l 6©7�O 5 �� �� Lot No. Site Plan Name: Block No. Project Name: &Oc- Setbacks Front Back: Right Side: Left Side: T. ,4•,.u{a�_?r�,�.;...a�}r.,.' t�, �"'= i.�'...�.,.w �zr4.,,'�,Z.3'F €""'�'.��a '. ,s+�'r'� z`�,%-�,'i'x-�"n"`,•a..�' .a .�. ,w^ar z--.�' ,S r� �uw�-"� �` ., �� �Vi "06-.._.^{x' _ •-s- s .tea l-.�i fe-u a+- +"a,'t' .�P; a.:.x ..,.a '};t`{'a, a .., a '_.:, .,kr �f"., �A c� � �{-r�'3'.-'t nt;r;.-:��a..,� n4`'� �... n''�''r'1w.�aS,"rf�... -�+k$ ,a t,:, ! .ir•,rx;�=-. r `�.�it,lr"�h?tr'�7N. f�cor•`�= 4: Additional worto be pertormed under this permit–check.a tat appy: `Mechanical _Gas Tank T Gas Piping —Shutters �indows/Doors __..Electric construction: Plumbing Sprinklers —Generator Roof Total Sq. Ft of Sq. Ft.of First Floor: Cost of Construction:$ oZ,' o 0 6 OCA utilities: —Sewer —Septic Building Height: 3r..9'�...-; „ „iSr- .=r's..a..i .-,, r x :'�Y,�»,ni* .: - f t.�.:��..�jy�.y'YJ � : #-4.,r,.�.= }.z.�'..�;. s--sd ....s, < .^`�w �,.;�".7-ec-p*:'u 2�. �" `•i...w-.�:�"�. .Name 600c _ L Name: s�{ _o Address: l PGfvLd[r� Company: City: -�?� \�`�' State:'f:(- Address: \2\,O ©S o ��.d �/�D � cl- State � Zip Code: 3��5 l Fax: City: Phone No. 7 ?�' �1$ Zip Code: 6 Z- Fax: E-Mail: ( Phone No �7�a �'�` 6g�-3 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. # i ;x :, S 1 Fn _R� `' SUPPLE�tI.ENTAL C®�tSTRU.CTIONL ENIW NFO.RMATt®Nor -na, '".".a' „ `�° r-, Y.±. 'Rx r�"'S DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY Not Applicable µ Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: of 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 your Notice of Commencement. Signat Owner/Lessee/Age Signature of Contr r License er STATE'OF FLORID4 STATE OF FLORIDA COUNTY OF inn ems?/- COUNTY OFZw�- The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this 7A day of -,Ti/re-- 120_V, by this 2,k-day of ✓�� ,2016 by (Name of person acknowledging (Name of person acknow ging) (Signature of Notary Public- to of Florida) ( i ature of Nota Public-State of Florida) / ISAAC PEREZ Personally Known V OR M""'Y"P""�L.erQkR%@ a Of I�rrdas ally Known (a;�5P1npv juced Ident PSAEZ Type of Identification ` f Identification ?_. a�s_ Notary Public-State of Florida My Comm.Expires May 1 Produced ,; Commission#FF 08 066od CedMy Comm.Expires May 18,2018 Bonded Assn. %f,OFF�°�` ommission #FF 086006 ��n ° •��,���" Bonde National N� Assn. Commission No��V �G 'Seat] �� ''C`om fission No- /� REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 7/2014