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HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: - l Permit Number: I I l(J RECEIVED . JAN 0 9 2017 Building Permit Application Planning and Development Services PERMITTING Building and Code Regulation Division St. Lucie County, FL 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: �Pj,,��>� f;on PROP+SED INPROVEME R,T' OCATi'ON: , Address: /0 72 5- S DCe.Gti Di:�`y02 Te ise,) &4c/ , /C L• 3Y�17 Legal Description: Ho may nU f a� S/- Ll C/, �'710 Yl 3438 -79.x) Property Tax ID#: g5-11- 5-02`0/Z 7 000 —7 Lot No. �D Site Plan Name: &1,- 4Y 0&f Block No. Q Project Name: /01 10)- Setbacks Front Back: Right Side: Left Side: DE AILED DESCRIPTION 0°F WORK:: Coir e e eMo%' ion ,e ry0v,?l 0 7 7C/O/,%,4 roa-m CONSTR�U�TIQI� INF©RM TI©'N: Additional work to be peffo-rmed un er this permit-check all that appy: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Construction: 712- Sq. Ft.of First Floor: 712 Cost of Construction:$ /7.0 0.*,, Utilities: Sewer _Septic Building Height: ©W,tIV,ER/LESS, E: alms= Name LDS-: /1. �.C�✓1e Name s Address:>I07...23 .f OceQh 0'r. / wC�- City:` ITO»,t2n /?e4c� State:FL; Address. 5S9e,?,-e,^ Sf. Zip Code: 31(757 Fax: City: SenjeA 3&4e-"4 State: /AL- Phone No. 7 7,2- 2 2 9`31 y 9 Zip Code: 3 /95"7 Fax: 772-),32'.2191 E-Mail: Phone No 7 n 37/5 Fill in fee simple Title Holder on next page(if different E-Mail 4Wain 5-A /fLi i C yo/aa- cow from the Owner listed above) State or County License GAG /,2 /Cj/a'/ If value of construction is 2500 or more,a RECORDED Notice of Commencement is required. NIPFLENIENTAL CONST ;UCTI®N LIEN LAW INFORM TION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: tate: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicab BONDING COMPANY: Not Applicable Name: Name: Address: A ess: City: City: Zip: e: 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 orprohibit 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 Notice of Commencement. Signature of Owner/Lessee/Agent Signature of Contractor/License Holder STATE OF FLORID STATE OF FLORID COUNTY OF . jn COUNTY OF x;11 The forgoing instilment was acknowledged before me The f o�rgoing instr ent was acknowledged before me this�day of 20n by this l day of 20�q by (Name of person acknowledging) (Name of person acknowledging) (Signatu a of Notary OLTblicJState of Florida) (Signature o otary Pu ic-S ate of Florida ) Personally Known OR Produced Identification Personally Known OR Produced Identification L' Type of Identification is Type of Identif atio Virginia JW m NOTARY PUY Produced �. X11 �oduced �� � o� NOTARY Pt C STATE OF F ORIDACommissionNo. Z__* CamNr FF92 remission No. pZ 325 STATE OF RIDA Canrn#FF9 1 Expires 9/23/2019 ""%%!"'iii¢ Empires 9/ 3 019 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev.