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HomeMy WebLinkAboutBuilding Permit Application i ALL APPLICABE INF ST COMPLETED FOR APPLICATION TO BE ACCEPTED / Date: � C>I- I Permit Number: f f 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 Address: 4-qQ0 u- n daQ OaAj --t- Pi e_qr� FL, 34914-7 Legal Description: LA) 50 1 la+- ti. one Ld57-3 - Property Tax ID#:�,J�,�� �Q�_ p©(a 7 - (�C�D a Lot No. 3 Site Plan Name: g,-(er,oIe _,e ���pQef,5 Pere, Re-5` C�'� Block No. Project Name: �l�►, [e 0_E I Q P S - Pef'f-, � r Setbacks Front '75 Y1, Back: Al Right Side: r�Left Side: r, [DETAILED DESCRIPTION, FVORK "F, rl17'' ©� 41 i/i h i C, Y 0_ W r 1-� P I C 4Z_+7s a ►w L-6/5i" �- y - 917 , (NFORMATION� .....�, Additional wor to De nerrormed under t is permit-check all thatappy: HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors Electric ❑Plumbing Sprinklers FIGenerator Roof Roof pitch Total Sq. Ft of Construction: /6LL� Ll= Sq. Ft.of First Floor: Cost of Construction:$ �`%Jr Utilities:SewerEl Septic' Building Height: s. _. _ _a ......._„ -,z.,,bi .t, „�,:3..•.�.d�i'.,z„. Y,x:.e;*„ ..»::_K7 ._ ., ..,r..,.n . ................ '. h, .O a Via'* .. u NameName: Address: *(ru i)_-c4cf5&LnQ I,t)o_,4 Company:_ �l�-� r►��P dV�n(}�1 City: State: !—L Address: PI} 6b4 a-((23(n Zip Code: -34-i!49 Fax: City: 54-(.t0JJ State: FL_ Phone No./Y)CI:v 1p-4rGt r r�e, IBJ. ld-W6 77 cW/r Zip Code: ,34'?1 Fax: T1,!2- 9 W-3035 E-Mail:6_[3tJ. ( ���' Fill in fee simple Title Holder on next page(if different E-Mail: �d�t-r_a i ee, ip 6e_.I.5(}(..r from the Owner listed above) State or County License: If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPIEM NT�0.E�CC}NSTT�UCTION "'N VFW INFQRIVIAT[{? 1 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 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,1 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 recording our Notice of Commencement. s Si a e o caner/Lessee/Contractor as 4fgent7dr Owner Signature of Contractor/License older STATE OF FLORIDA STATE OF FLORIDA COUNTY OF AAR'7/N COUNTY OF �1 The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this.'LP"day of. 1�7'C.� 8d R 20 L(Lby this��;? of � 20 �by _(FFeu bowees S+ �},�5 tick rvl�V1 ou (Name of person acknowledging) (Name of person acknowledgingULQ ) 11111111 (Signature of Notary Public-State of Florid � ••••••••••4f�iY,,A (Signature of Notary Public-State of Florida) ���c • .1 COMM/s••c0 VX Personally Known OR Produce ntific�a �in>6 s%•9� personally Known L/OR Produced Identification Type of Identification Produced `�hype of Identification Produced —�• : Commission No.FF/�7 S!ol = �F� �•sj� m5a�i ommission No. :=o:............�� e DIA Ea BOND �i��'•••.;' nv�t.RMY COMMISSION#FF185430 V*/-/'�101N1110P�\\\\ ?oF; a, EXPIRES December 28,2018 Revised 07/15/2014 (407)369.0159 FlorldeN01yfySorvice.com REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS