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HomeMy WebLinkAboutBuilding Permit Application 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• ur failure to Record a Notice of Commencement may result in your paying twice for " improvements toy r" , o ty. A Notice of Commencement must be recorded agAlaqsted on the jobsite before the first i ectik'71f�ou intend to obtain financing, consult with lendop-6-r an ey before commencin or,fe'cord(ng your Notice of Commencement. gw Signa a of Owner/Lessee/Contra as Agent f Signature oMontractor/Lice e-wekrer' A;;;-5 I I STATE OF FLOR STATE OF FLORI I@ACOUNTY OF V5COUNTY OFget 0- UJ XThe folgoing instpffll(�nt wasl acknowledged before a- The forgoing nt was acknowledged before e r X i 1-7 this day of 20 th S,,(Pay of Y 12 by J4eve &�,P_Vlv 6u-v9 sz�e V 7-,V AI&UW (Name of person acknowledging) (Name of person acWriowledging) I ,.1611 OIL (SignatureYlotary Pub Stat (Signature of"Ory Public-S—taFe of Har da V 7' V /""" 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 Rev-7772014 All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /y Date: 2.3. � 1-7 Permit Number: Building Permit Application JAN 2 3 1017 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: Address: SJ In r l ii IUA 14Ui✓ '�- Legal Description: I. J Fk�C.44f a to klikG AU-Ot A11-1-OtJ S Property Tax ID#: 3gti <� '0 2fo 0 7 Lot No. _ �i Site Plan Name: P-�'"�d���� Block No. Project Name: Setbacks Front Back: Right Side: Left Side: alzft- Additional work to be pertormed under this permit-check all that apply: _Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors Electric _ Plumbing _Sprinklers _Generator Roof Pitch Total Sq. Ft of Construction/: 2Z ov Sq. Ft. of First Floor: Cost of Construction: $ (pc��D'� Utilities: —Sewer —Septic Building Height: Name F-A C411h6AAI f Name: Address: 2 IZ (L�►� I�(Le�-�C LCL Company:dAs�-kCe City: L C pL��y.,;- State:rL Address: .5 Ak PG Zip Code:,3j�l _ Fax: City: �'I G�F� State:G2 Phone No.`�77� �Z� 72�� Zip Code: Fax:7�Z �ri(ml"(eC�(r5� E-Mail: Phone No -)7L Fill in fee simple Title Holder on next page ( if different E-Mail eA!am.y ot h444tr ' from the Owner listed above) State or County License�G©�SJ5�7lOZ��1 If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.