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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: 10 2-Loo 2 I (�Permit Number:. © q c C 1 H V' ; Building Permit Application NOV 0 4 20%, Planning and Development Services PEWHTTIi IG Building and Code Regulation Division St. Lucie County, I'L 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X _ PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PfR0Pfi0SED IMPROVEMEdVT LOCATION h E z Address: ri , rnioear) n Legal Description:��rn GrWC Slp BU?, 1A t.pT 1 h•1-:5 A6 COQ 359 1-- 2211 Property Tax ID#: -6hrll { Lot No. __L Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DET4�ILEDDESCRIPTI'ON �.t_n i - l i� r cba(Ccoy, Coadtn�� 6�i��.t a l-�p ` �eee� MU`!- &L. 15NA-U41 t-t5`4-GL NA-U:J Vk I� BTU r { CON,STRUCTIO$N INFORMATION T s J .:, -, Additionalworkto e n ertorme ���un er th is permit-c ec, a apply: HVAC D Gas Tank ❑Gas Piping _Shutters Q Windows/Doors 11 Electric 0 Plumbing Sprinklers Generator Roof Roof pitch Total Sq. Ft of Construction: SFt.of First Floor: Cost of Construction: $L}Ibbbn Utilities: _Sewer E]Septic Building Height: OWNER�LESSEE t t � CONTRACTOR >, Name lA Ci ('A 01.11 b Name Ue Address:,_-_3(Q1 eUt- 1 Company: k IL t City: �rar �le(C� State: EL Address:(001 S.-N AhrVk(- P.Il.tle Zip Code: Fax: City: ��-.�lerce. —State:-EL- Phone No taterPhoneNo. 2D3-- 55C)q- 99-A9) Zip Code: 3U19)2 Fax: rirm- 4to6-qq`[�! 6- E-Mail: Phone No. r 17 - Lk05 I UG(,0 Fill in fee simple Title Holder on next page(if different E-Mail:(Id Um ,- ---As@ h MI1 i 1. Cpm_ from the Owner listed above) S ate orCounty License: G 3 cyC 0 (D(DU nA, . # . 88? If value of construction is$2500 or more,a RECORDED Notice of Commence ent is required. SIJPPL.EI\/IENTALC� NSTRUCTIOyN LIENLAIN INFORMATIONNO 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, 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 inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording our Notice of Commencement. 7'6- nature of Ow r/ essee/Contractor as Agent for Owner Signature of Contr ctor icense Holder STATE OF FLORIDASTATE OF FLORIDA COUNTY OF ( 0QIr* 45 COUNTY OF PJ The forgoing instrument was acknowledged before me The forgoing instr, ment was acknowledged before me this&w day of 6er 20 Av by this day of {0P_ 20 j(,o by ��) ptmu& I urhow (Samud T lutham (Name of person acknowledging) (Name of person acknowledging) ��V14�OIIi190P1q Signature of Notary ublic-Staff too, (Signature of Notary P lic-State of Florida _e 21 20"°'P • g\�iNI4111dddd Personally Known V Oi�roi �d Ide�tificat;�= Personally Known��OR Prod Type of Identification Produc :�� IF •¢�- Type of Identification Produced _21A. �`�s ?1 FSA'• YP � YP Commission No. 0`41, ( ic; odd Commission No. e° J�•.•�'ary'AY6• P�0*yam �i� 4?59 •¢'.d °°>ioRYPUBUC Revised 07/15/2014 pmB/l;14s0 1'\\\' REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS