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HomeMy WebLinkAboutBUILDING PERMIT APPLICATION.PPLICABLE INFO MUST BE COMPLETED FOR APPLICATION' TO BE ACCEPTED Date: I - 5- ( (0 Planning and Development Services Building end Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: Address: Legal Description: Permit Number: Building Permit Application Commercial Residential � Property Tax ID #: Al -12(p -- SS 1 5 - Lot No. Site Plan Name: Project Name: Setbacks Front Back: Right Side: Left Side: Block No. L lie _�- /s 5eW ChAnse- ���h/fi"" nai worK to be performed—u Mechanical Electric — Gas Tank _ Plumbing Total Sq. Ft of Construction: Cost of Construction: $ c-© o . 0 O _ Gas Piping _ Sprinklers Shutters _ Generator Sq. Ft. of First Floor: Utilities: _ Sewer _ Septic Name ._3 hc, Address: 1 City: State: F L Zip Code: 3CI1iq 0 Fax: Phone No. _'I Q E -Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) _ Windows/Doors _ Roof Building Height: Name: Curtis Savnrnon S Company: (',us-r,m A t'r- Sfems otic. Address: [l l S S 6 r l (c2a P_ Q rw.n_ Dr City: ry2T ST LkC i State: rL. Zip Code: 3425k) Fax: ' 7; J3S Phone No. 77,E 33,5 "3-Z32 E -Mail: (Lu stQ1- Sca < V C10 1 •r,M State or County License: CA C 0 5 ),F 10 I if value of construction Is2SAWor more, a RECORDED Notice of Commencement is required. -7e�0 Not Applicable Name: Address: City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: _ Address: City: _ Zip: Phone: MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: BONDING COMPANY: Not Applicable Name: _ Address: City: 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 recordiVg your Notice of Commencement ,4 Signature of Owner/ Agent/ Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA n COUNTY OF LvCk 2 �,�� `� COUNTY OF �� L�.0 �� Ce),') �- The forgoing instrument was acknowledged before me this 5 day of 20_ke by A- (Name of person acknowledging) (Signature of Notary Publ' State of Florida ) Personally Known OR Produced Identification Type of Identification Produced ,Ryr Commission No. C� F a9 1595 4o�s5 REVIEWS FRONT ZONING COUNTER REVIEW DATE RECEIVED DATE COMPLETED The forgoing instrument was acknowledged before me this - day of 20 F by (Name of person acknowledging) (Signature of Notary Publi - tate of Florida ) Personally Known OR Produced Identification Type of identification Produced my CRL OFS2 ( EXPIRS: Semb5,19 '= Fa *µ"P*(�_Q®RALJONES mission No. .2 7 S � `� $S{qN i FF 227575 _ E)PIRES: September 5, 2019 SUPERVISOR PLANS VEGETATION �SEATURTLE JMANGROVE REVIEW REVIEW REVIEW REVIEW REVIEW