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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: ���` Permit Number: LZ NOV 18 2f 0 10 ..__.__..__.__..,_,..,.w..�.R....� .Y....__��...._.e..... .....W. Building Permit Application PERMH FFING Planning and Development Services St. Lucie i OUnty, FL Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce ft 34982 Phone: (772)462-1553 Fax:(772)462-3578 Commercial Residential PERMIT APPLICATION FOR: _,�.,.'ss �. [k ti,r S�i;si CCp � irAt Address: 6O Db8a brwe, t 3 al Legal Description: .�GLG4 ,�6 Qq- - i�0 __ . �^-1 Ace+ Property Tax ID#: 7-?�03--2,"t `-'Z —C9C6 ".�+ Lot No. Site Plan Name: 4 F?✓1 �Q Block No. Project Name: Setbacks Front Back: Right Side: Left Side: "DET7�ILEDDESGRl�T10►N.OFr�tCfRK �"{ � r^ tet, v t+re" T � -�a � ,r� 4� }y , i m > '��`�� ���'+ `L t¢?�r., a� a3 , �, i s } # s Rx S➢' } 1 {+ Y r i v q +aa +y+tc r F ._'1 .t ga -5 3 CC►NSTRL1CTf03�IIVt'ORMAT�ON Additional work to be performed under tis permit-check all that appy: _Mechanical _Gas Tank Gas Piping `Shutters _Windows/Doors Electric _ Plumbing _Sprinklers _ Generator Y Roof Total Sq. Ft of Construction: soo- Sq.Ft.of First Floor: Cost of construction:$_ 5649©d Qd Utilities: Sewer _Septic Building Height: �Q t Name Lc^,1.5 t`7or��t�E_. Name: Company: C City��bl �t .- StateL._ Addres l Zip Code: CLAS Fax: City: State: Phone No_ 7`lz"�c{ j'—`-+= y Zip Code: 44 F.X,7 2- E-Mail: Phone No -772,`� S S Fill in fee simple Title Holder on.next page(if different E-Mail , from the Owner listed above) State or Cour ty License__6 0G7 73( 6 146 at. If value of construction is 2500 or more,a RECORDED Notice of Commencement is re fired. T Si- �,. _ t�,. •�. ,,�, 1 -.t, ti ,u F;, RMATION SUPPLEMENTAL CONS=;RUCTI zLIEI ,LAW,.IN � ;" �1. i � cirF .i,. •L .n - k� ,�a.Y,L.r;'.t .t., k r_ .,a...+,t r.e .x .n.,r,,.r..: .it __ ,r .a.:- Ssrj.? ,r. 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 made to obtain a permit to do the work and installation as indicated., 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 commiencing work or recording our Notice of Commencement. Sign u0 d Owner/Lessee/Agent `"` '' ignature of Contractor/License Holder a STATE OF FLORIDATATE OF FLORIDA / COUNTY OF m OUNTY OFMw cn The f r ing instrument s acknowledge before me I ggg he forgoing instrument was acknowledge before this day of J']y ,b Y :mE m y J) Y 20 b mm< his da ofd r?J� ,20 b b ®Wig—= Inl �.-arsedV ' h `ON� (NatZefif person acknowledging) Name of perso acknowledging) i a (Signature of y tary Public-State of FI ida V (Signature of N t ry Public-State of Florida) CA��� Personally Known OR Produced Identification Personally Known OR Produced Identification. 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. 7/2014