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HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST.BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: �,��0 1 Permit Number: • .rri. 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 PROPOSED IMPROVEMENT LOCATION: ,r� Address: i-4901 }G1,V a '/2— EIY•V� [AV-P_ �- i Z� CR � 3� �J gZ Legal Description: %T'Z C44 w t ti I 0� fv (ZS . v�P.S -200 FV o-P L-3` 1D OVVId. N 12 Fz�_: 0 F S 0 a-� f 2� E+ 0 r 11-7 (6. qb r4c)C0e 70 - Property Tax ID#: � qOq- O - 0C 3 Y - © 0 O - Lot No. 3 iS Site Plan Name: Block No. Project Name: M(f 1 Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION,OF WORK: CONSTRUCTION INFORMATION: Additional work to be nertormed under this permit-check all Ma appy: ❑HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors ❑Electric ❑ Plumbing OSprinklers ❑Generator ❑ Roof Roof pitch Total Sq. Ft of Construction: S Ft.of First Floor: Cost of Construction: , Utilities: _Sewer[]Septic Building Height: ' . OWNER/LESSEE: CONTRACTOR: Name I� 2 2eY c,'!1 Name: r% ' 11 \\ d SS Address: 1}90 ) Oyv�.e� 112- �)Y,. �Y-e• Company: V.1 f-��r r i c-An e ��J �J • , City: - 0 i y'CQ State: [ Address: 11 0 0,. � J/1 j � L- . Zip Code: � 9 9,"�2 Fax: 1 9 Y - ?S�o City: - i Zr('O Stater Phone No. -7•72- -7 q'4- /S'�� Zip Code: 3L 9 S 1 Fax: 159 E-Mail: Phone No. �2_— _?9 C4- 1.5 go Fill in fee simple Title Holder on next page(if different E-Mail: d ti�uV r IN calge_c�u,�-Vfr-s c o-' Q hA- from the Owner listed above) State or County License: If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION-LIEN LAW INFORMATION: DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Name: Name: Address: Address: City: I 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. Signature of Owner/Lessee/Conti Co ctor as Agent for Owner Signature o ntractor/License Holder J STATE OF FLORI� LUL(2A—Q_ STATE OF FLORIDA �LL�COUNTY OF COUNTY OF The fgrgoing instrum t was acknowledge fore me The forgoing instrum t was�a..,,ckn�owlecig d before me this day of 20 y i his_L day of 4CAc� 20 �by \/CL rN We\ 0a in --roo-a'a_p_ (Name of person acknowledging) (Name of person acknowledging) f I 14 (Sign ure of Nota ublic-State of Florida) (Signat otary u lic-State of Florida) rsonally Known OR Produced Identification Personally Known OR Produced Identification Type o kation Produced a of Identi d ced Commission No } Commission -1:a* - ANGELA ANGELA M HUFF • * Public-State of Florida * .oP OAA­ommission#FF e Notary Public-State of Florida - mmiss on#FF 234730 -''•�u�u���` xpires May 27,2019 ' �• ; ' MY Comm.Expires May 27,2019 BondedthroughNational Y 2 Revised 07/ 5 ? '' Honr,ed through National Notary Assn. Y Assn. •� • �... REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS