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HomeMy WebLinkAboutBuilding Permit Application ALL APPLI BLE NFO MtPST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 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 PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line fix" ,.t»$€ c+t:xt rtv¢. °S', Address: ( t I U-) Legal Description: Lak x-wood rRQrA : - (,I\V1 Property Tax ID#:__ ® � ~—�� i -- ( 2> ( o on � Lot No.�_ Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: 'ws�c" , •: r''� z HLA" � a :rid {a '. 4 � a h, ? p, 3 ' ,actl ;s^ *r s c r ;, 101- "k ' tYn "hR n"a. .w.w. a4 �-'s. , -"1tY-'+ MOW _1 �f (w"�.tr..,_ f .ei_5, ,.z/':\_ 3 is c• r .t3k I T/CL t�.J� ` C9 CtG� C•c G� � � ► � 0 (' C� � rX �.ReRRW Fes'�xE f t . 9� � cry 'Z a r ��^.e•�' '`�n��', � ��`� ��` �3...,•; Acid itional work toe e orme under this permit—check a appy: HVAC []GasTank Gas Piping En Shutters Q Windows/Doors Electric 0 Plumbing ❑Sprinklers 1-1 Generator 13 Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction:$ Utilities: Sewer F]Septic Building Height: e ,.:. c" Y'�-4 ax'k � m w ''b,Tq ,v...+�'�s'rvz'.3°t+s.� `CgTWf�X'�• �Sir=+�§'�' r-�;�(xl,,� #•�F�:;.... e� �:�.r::Y"'�" f��� .�.`en-rc.i�'�<2:i=}r+'�3s'�•°`xt+ �� ''e'�,�fi� 4." 'f5!ail.'✓i '""�' � x s�`r+."r��r-.cccc""' �` ���.��'A:�`�3a����s • .+c._h._.��..dk`- �. ?k"..^�' Name Y1 > Name:_ CA ` V Address: �2 ompany: •n h City: I-Q d State: Address: �--Ct" LN C t Zip Code: 'i Fax: City: 164 po 1`'C.0 Stater[ Phone No. f rl j Zip Code: _ ( Fax: E-Mail: Phone No. \\2 -. 1 6 5 CD Ll Fill in fee simple Title Holder on next page{if different E-Mail: V.A C(td 15 from the Owner listed above) State or Coun4 License.-r`'f," r 0 6 6 If value-of construction is$2500 or more,a RECORDED Notice of Commencement is required. .- �S 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 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.pians,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. _ ignature of Owner/-Lessee/Agent Signature of Contractor/License Holder STATE OF FLORIDA t STATE OF FLORIDA ` COUNTY-OF G � COUNTY OF ThejorQin instr ment as acknowled ed efore me The forgoing instrument as a knowledge before me this 4©qday of 20 p this day of 20 �jjby 7yt (Name of person ack owledg'"g} (Name of person ac owledging} (Signature of Not (Signature of N tPublic-State of Florida} a .`"YA",. ANGELA M HUFF •,SPa UB�� Personally Known ?°• 4 P >zedbY f" #ip� Personally Known OR Pr aced Ide+�it"tcation Type of Identifica o isslon 4730 Type of Iden a,•orl,,A r kic 1 +•F °a�.' Y omm.Expires May-27,2019 3,�4`1-0"A * Noiar ANGELA ha M FF i Bonded throb al Notar Assn. Commission No. = * ".= Y Public Commission No. v _ _ ,oma; °mmission#F °t Florida „°P' my Comm.Expires F 234730 h National Motarygssrr Revised 07/15/2014 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER : REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS