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HomeMy WebLinkAboutBuilding Permit Application ,All APPLICABLE INFO UST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �f Date: a Permit Number: MINARECEIVE SEP 2 2 2096 Buildin 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 COM ercial Residential PERMIT APPLICATION FOR: PROPOSED IN}PROVEIVIEIlT LOCATIQN ' ; , � r v. �,� Address: S 6&fmqA1Y Legal Description: 0 lv Property Tax ID#: 3.?.90 'Qd0y 0 Lot No. Site Plan Name: M4 1),A r L Flo lcl 1'p 401- i Block No. Project Name: Setbacks Front Back: Right Sid Left Side: �2 rn ru 5 CONSTRUCTtQN INFORMATION w Additional work to be performed un ert is permit—ch 'ck a t at app y: _Mechanical _Gas Tank _Gas Pipi g _Shutters _Windows/Doors _Electric _Plumbing _Sprinkle s _Generator _Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ 0L X00, Utili ies: _Sewer _Septic Building Height: OV4/( ERjLESSE 7 , ONl"RACTOR ..�:� nom. .>sr_�•: Name Freo( k,,%es / uP /YeS 11 e: CpAV -e P �! ? Address: 7�/�S / 6,er'/h19� C.9.��� /�cf C mpany P C,� v Q�A� L°o. � J✓e9 YA'm City: 1�-��f �Pr State:144 Address: J-3/ EM e r 14 101 /gy-<- Zip Code: Z Fax: I City: P .���/'�� State: OCL Phone No. 7�.7- 572-010'7 Zip Code: .4/?i� Fax: E-Mail: Phone No Fill in fee simple Title Holder on next page(if differen E-Mail 0©©f-er eA OL6 . cow from the Owner listed above) State or County License If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. SIg+ PLEMENTAL CONSTRP` CTION LIEN LAW IN HORMATION, 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 rr?de to obtain a permit to do the work and installation as indicated. I certify that no work or installation has commenced prior to thessuance of a permit. St. Lucie County makes no representation that is granting a perm' 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 an review your deed for any restrictions which may apply. In consideration of the granting of this requested permit, I do he eby agree that I will,in all respects, perform the work in accordance with the approved plans,the Florida Building Code and St. Lucie County Amendments. The following building permit applications are exempt from unde going a full concurrency review:room additions, accessory structures,swimming pools,fences,walls,signs,screed 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 finapcing, consult with lender or an attorney before commencing work or CWrclio your Notice of Commencement. Signat odder/L ss a/Contractor as Agent for Signa re n act icense Holder o � STATE OF FLORID m< STAT F FLO A g:20 COUNTY OF • �oA COUNTY OF a mem �coviQ wax The forgoing instr ment was acknowledge before ife R The for oing instr ent was acknowledged befo e thi day o- 20 by �g this day of 20/ by �T N z3 —TU)94h 1A) M _ (Name ofer on acknowledging) (Name of p rso acknowledging) 0 /2, Al"A. ' Q�114411-r 'K."d., ,�` j. Lor (Signature of N ry Pub' ate of Flori ) (Signature of No a Publi/c-State of Florida) Personal) Known 7OR Produced Identification Personally Known � OR Produced Identification Y Type of Identification Type of Identification Produced Produced Commission No. (Seal) Commission No. (Seal) REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.