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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST/BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: • OS-1 Z> • 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)46e-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line ON © h Address:nL. g1 c � f� J�� -��,�-5h _ r ?i L- to P/ 8166 Legal Description: C&.4 of cue- e- Property lax ID#: 3 3 L f 63 p o r v t3 j Lot No.&3� Site Plan Name: i^�c. yi' �+` �-- Block No. Project Name: SetbacksMxr.. Fro�nrtl Back: Right Side: Left Side: D'OS 7771 ^r'ff e_ t (Gcc�. F_r�> vd eA;� «),r n� de ;),^ 1Nl"Ci rtlilll i"n''% Additional work toe performed under this permit-check a appy: HVAC Gas Tank Gas Piping _Shutters 2windows/Doors OElectric 0 Plumbing Sprinklers 11 Generator F�Roof Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ 2-L100 Utilities:Sewer[]Septic Building Height: Name e h Name: Lo r'4!s TJ c. n Address: '71111 ?J"A W1J-,'0Company: C-D (t. City: ? State: Address: �P Z3i Zip Code:3�JL Fax: City: 5f'/mc State:_(_ Phone No. . !I o L-SCS 4._ i 1 o 3 Zip Code: �3" I Fax: E-Mail: Phone No. rl,61 —2..$-6 i Fill in fee simple Title Holder on next page(if different E-Mail: L r 10vr -rs from the Owner listed above) State or County License:_ __ 7 3 "d + t_ If value of construction is$2500 or more,a RECORDED Notice of Commencement is required, 1iE 1 ' .C 7NSTR TlE N LIEN LAWN C�RMAT10 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: 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 our Notice of Commencement. s _Signature of Owner/Lessee/Agent Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF M f0_1 I N COUNTY OF M A QA i N The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this l�day of JU►r1� , 20 IV by this 1V day of c�t�.PK_ .20'%V by (,L)C 9 S _T��C'L­o^ L".)rf 15 TDA,,, (Name of person acknowledging) (Name of person acknowledging) ignature of Notary Public-State of Florida (SIgnature of Notary Public-State of Flor da) Personally Known %.,� OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced Type of Identification Produced Commission No. F( 131 q,3 (Se4 SHAWNA mission No. 4 51-31 Me (Seal) aHAWNA M NOTARY Pt IBILIC NOTARY - TA ST*rI!OF FLORIDA ATE OF FL IDA Revised 07/15/2014 Corte FF1318W Cm n#FF131 Expires 6/11/2018 Expires 6111 18 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS