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HomeMy WebLinkAboutBuilding Permit Application 10-23-16;23:06 ;From: To:7724621578 ;7724618722 # 2/ 4 ALL APPLICABLE INF9 MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I Date: © � : Permi f L k O Q t Number:_ jl �w. .. •.accr Building Permit Application OCT 6�1 Planning and bevelopmentServices PER[-.41TTiigG Building and Code Regulation Division 5t. Lucie County, FL 2.900 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1555 Fax: (772)462-1578 Commercial Residential X PERMIT APPLICATION FOR: To Select from dropbox, click arrow•at the end of line `.; ,: � .^• . _..,�, ... ,Y,.. u.,- '.,•.:•;ter, .\ 'r. :;; ::,: `a z •ry� .;v,-_, .:t�'t�titi ,, ;,rc,„k>.,h,.;;„ .:,:�c.;,� �t.� 0R4:p0�` A/! ��// NN AA c. ,;,C z ,\rt.,l"yf'.,:.,•c._' .4J,. `rti ;i''.ti;l Vis, :� .,e, SEp,_I;M'PI3O^•V•;�9V1: �I�a z:,l_O. r�Fa`-�i•1•'!!S�ti:,ai%.\.a,'.,, �,�t, ,,, ..�c� .\�l.n. ^f•,._'�l'oo- ry%S'i;r' - �.IF„ =�t��:�'= .., E •T,. ,CATION;: ,,ri,��_.,� ,,•�„ �u.l,.h,.;?„{,.v _S+hf:v:?'e;,R.:, ll,.d'}J;4,dyr/1 rqJ,{ Ycai„'•i."�''r'�r.,.t„�i(,��. ?r','P'��'��'•�':�- '.i. ,;/rr7. ,\,. :u.., ,.1. t .:s.r1.lis;,�!,!:,li.,.=�Gt•.;::!_;;,:y:.. ,;;-�t?`;,r<:j7 Address: & :L91 / 1r - Legal Description: fV&7L-& ,V' ` G�m Property Tax ID#: -3.!K02- 7 no/„[��92Q o_p Lot No. _ Site Plan Name: Block No._,�.� mm Project Name: Setbacks Front— Back: Right Side: _Left Side: W11, /�.�}Y/>,•y h.• ki Jr;:ba: '�,O.rFlft`i�. 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'i_ n. ,.� a. "'d)\��.;tY;(�Jgi'.�JtS�;�.y r�I n'.u.S``5�!: ,p.. ,E`,XFa.ti�\. ;:•1,a)q% �.;4 S,U.P.PLEM:ENTi4L;.Cb.NSTRU; TI.f�,N.?LIEN LAW-,INFC�..RMa71bN..,, a�'.., a ,4} +•,,.a.•,.ti•: `a..• 3.. -.,i• , L., rr!c.;n r.,titi`ir.(%:;i.64 E*•),,.�.i'4";r.,..r—i£t;;q%;5.,�>: 'V ••,.t"._„';F ;'�!i;?�;tivr-t::t�.r.-,•,,.hsa.r,•.:-}`iit\\(�.ujS:a„f.�.'�0:,�.,;o;r..\.J.trt4�,�::.A?=r�'isf�x":ti',`•,li�:�rth3;��;ri�}t`�i�+,�' ' m•>,q.•,. �, �('7�.�,w�'C�'}T+Zs DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: A 4 41 Address: City: State: City: State: Zip: h e• 1 F zip: Phone: FEE SIMPLE TITLEHOLDER: _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 Count makes no representation that is granting a permit will authorize•the'permit holder to build the subject structure which is in conflict with an 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 consfderatlon of the granting of this requested permit,I do hereby agree that 11v"ill,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 accessorjr 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 tore of Owner/Lessee/Contractor as Agent for Owner . SI ture of Contractor/License Holder 5"CA7E OF FLORID STATE OF FLORIDA COUNTY OF ?r �L[G�/� COUNTY OF _9n. 4,4ee_l !' The forgoinginstrument was acknowledged before me The forgo'(instrument was acknowledged before me this y of^e2ar]q L— 20//.,—by thisW day of&�� ,20 •1 by 1-41m.C,,,, „A• gr,,m r.. . ....... /fit c 1�_........ rin�4S' (Name of person acknowledging) (Name of person acknowledging) (Si na ore of Notary Public-State of Florida) ( A nature of Notary Public-State of Florida} Personally Known? �„�„���Producg�,��sptj( q�jy Personaily Known0„ ,�ra ucecj� � t. 111 Type of Identifica idmP +' _ Type of IdentificatronrP,Yo' ;, . F. � My comm.l:xPlt�s;.taP 14.2018 , '+ " �; My Comm.EXpir".%lar.14,2018 Commisslon•No. • °�:'� comml($W)a FF 071680 Commission No. m��:�� comm(S�pIYf FF 071G80 •, +4.11,+11!' Bonded Through Natfonal Notary Assn. +�yi,;�i,•`' Bonded`Trough National Notary Assn, Revised 07/15/2014 REVIEWS FRONT.• ZONING ••.•SUPERVISOR PLANS VEGETATION SEATURTi E MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE «, COMPLETE I�IISIAIG