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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ,r� Date: Permit Number: (goo- V5 -'s "NOR CU0211 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: Address: 310L4 iM, T=' S'Aq4`7 Legal Description: 5uj(Ay D 6-fte9gF0S 9LX_ aS- U>-Ts 1-2-A" o S3 Property Tax ID#: 2LIOY i6ol Off S-S 12Q2 Lot No. Site Plan Name: ec��s(C��t.e Block No. Project Name: Setbacks Front Back: Right Side: Left Side: '10 f c r Additional work to be performed under this permit-c ec atat appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator XRoof Total Sq. Ft of Construction: -2,yM.10P Sq. Ft.of First Floor: Cost of Construction: $ 0.ZM-' Utilities: —Sewer —Septic Building Height: - Name Lt S�'�2 w 6 �4t4 F"R��rv�ar-� Name: 1:3—r Address: 3(0 q AV9 uA ` Company: ('A�jorJfsc� VeeQf=A_ - �k..� City: P[,�-z c,,E57 State:Ftp Address: 3271 ©(eWJPI�X-r4Ve Zip Code:3 ctc�L{-� Fax: City: F-( -Neezt5' State:E Phone No. 4(oD 51 i0 Zip Code:-3WD% V2_- Fax: -7-)1- qGL-0k,�k� E-Mail: Phone No - -2- 2« go47 Fill in fee simple Title Holder on next page( if different E-Mail (,45T&i Ctt a Jg=ruNKy sw kt ,ww� from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. 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: 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 iR;�rec' you intend to obtain financing, consult wit I r an attorney before commencin w ord n our Notice of Commencement. Si ature o Owner/Lessee/Contractor as Agent for Owner Stgriature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF 2—, The forgoing instr ment was acknowledged before me The forgoing instrment was acknowledged before me this�day of _ ,261. by thi�day of 20_1 by �1 \'to A 111.. (Name of person ackn wledging) (Name of person acknowledging) n ure of Notary Public-S to of Florida 13enature of Notary Public-S to of Florida ) Personally Known OR Produced Identification---..'I Personally Known OR Produced Identification Type of Identification Type of Identificat Produced �" •��, LASHAHNA INGRAM Produced ,'�oa�"ba''- IVULaly rvrlic-State of Florida Commission No. ,�; My Comm.ExpiresiA940 1�02,49 16 Commission No. (Seal) Commissidd Bonded through National Notary Assn. LASHAHNA NGRAM i" REVIEWS R go" -S a�P R PLANS VEGETATION SEA TURTLE MANGROVE C ! YT N�yf�V'VExpire De REVIEW REVIEW REVIEW REVIEW DATE Bonded through Nati inal Notary Assn. RECEIVED DATE COMPLETED ev.