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HomeMy WebLinkAboutBuilding Permit Application li ti ALL APPLICABLE INFO.MUST BE COMPLETED:FOR APPLICATION TO-BEACCEPTED `! I � Date: � mss© I l� � E-_-�q�y �;E�� Perm'i Nu ber: T. lude Couniy ;gi AUG 3 0 2016 Housing Department IT I: P'IdTI ld� TE', ��,�rmit A � Planning AFFORDABLE ATTAINABLE and Building and Code Regulation Division (��(� 2300 VirginiaAvenue,Fort Pierce FL 34982 �8�� ��U S 0�V V Phone: (772)462-1553 Fax: (772)462-1578 Commerci ti j PERMIT APPLICATION FOR: Roof PRQPOSED IMPROVEMENT LOCATIC41\[:, Address.. _��� u /l' . lr I _ r.. l _.e,— N� _ 3 Legal Description: GcUn Z _A94 9 34.-'13 2-4-,9?JID Property-px.JD##:_ -:3 Yo p_�_- Site Plan-'Name: 11 'BlockNo. O Project Name: 01 Setbacks Front Back: Right,Side: Left Side; DETAILED DESCRIPTION,OF,WORK = e oul CONSTRUCTION INFORMATION: Additional wor to e. e.-orme under this permit-c .ec a appy: CHVAC Gas Tarek F19s:;Piping Shutters Windows/lDo.ors L�I Electric 0 Plumbing ❑Sprinklers IJ Generator El Roof T niz Roof pitch Total'Sq. Ft of`Construction: q SFt. of FirstFluor: CostofConstructioon:,$ ��S Utilitiest]Sewer lse_ptic Building Height: OWNER/LESSEE CONTRACTOR: Namec.K+el , -k-be- i I Name: 14 lJt--ZQs0 Address.: 5860 Com,puny:low_ .�S� 9`u to� _ City: TOt� �i2� _ State:_ Address• 5c�.� Zip Cade: z � Fax: rte City.: � erk Pho.ne.No. `3 4 to I Zip Code: 34053 _ Fax. 01601, E=lVlaii: 1'J f ,P:h�one�`NoQ7ZZ-l��� 2A4 T ~ Fill in fee simple Title Holder on next page (if different E-Mail: btp— h�l5e�W.S e4W I from the Owner listed above) State or County License:C4=- '33 O 1; 7-3 If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SU.PPLENiENTAl.CONSTRUGTI, N' LIEN LAW INFORMAT{ON` .DESI.GNER/ENNEER: Applicable FORTIS C MPANY: Not Applicable Name: 'Name: Ir Address: Address: City: State: City: Stafi : Zip: Pho e: Zip: Phone. FEE``SIMPLE TITLE HOLDER: _N pplicable BONDING COMPANY: Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: ell 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 WAkR NG Tfl OW IER:Your failure to,Record a Nottce.of Cairtmencement may result1n your paying twice for g: improvements to your property.A No'tice�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/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OFFLORIDA STATE OF FLORIDA COUNTY OFS 1• �w��c= COUNTY OF \- ��_� t; The for inn ins ument was acknowledged before me The forgoing instrument was acknowledged before me this�'�ay of t�S� 20, by this V-day of ���5� 20 by (Name of person;a.ckn.owl edgi ng.). (Name of person:acknowl edgi n.g) (Signat re of Notary Public-State of Florida) (Signature of Notary Public-State of Florida /� ) Personally Known 1OR Produced Identification Personally Known VubOR Produced Identification Type of Identification Produced Type of Identification Produced ,,,ti u...... �t i No.�e A-:,? . Commission No.�t-=����� PAULETTE GLAIR AICO G M •��� . Notary Public-St to of Florida ?° µ� Sys PAULETTE GLAIR-AL NDER __ Nofar FlorfAs 7-11Ff...•, My Comm:Expires Sop 6,2016 Commission 0 EE A 935 Revised 07/15/2014 My Comm.Explres Sep ,2016 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS