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Building Permit Application
ALL APPLIqABLq INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number: 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 fl PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line 0 PROPOSED IMPROVEMENT LOCATION: Address: Legal Description: Property Tax ID #:11 n (� f Ol Site Plan Name: Project Name: e Setbacks Front Back: Right Side Left Side: DETAILED DESCRIPTION OF WORK: U At U tC�, Uhf 1 CONST UCTION INFORMATION: Itlona wor to a er Orme under this permit — check ail that j app y: QHVAC Gas Tank E]Gas PipingLnGenerator J Shutters KElectric Q Plumbing OSprinlders Total Sq. Ft of Construction: S. Ft. of First Floor: _ Cost of Construction: $ UtilitiestSewer OSeptic OWNER/LESSEE: &a� i. . I� Code: I . M'Phone No. Fill in fee simple Title Holder on next page ( if different from the Owner listed above) ! CONTRACTOR: Lot No. Block No. Windows/Doors Roof Roof pitch Building Height: Name: CLX Company: 1 Add s: S� City: Q `( State: Zip Code: �J F Phone No��` �' �, �' E-Mail:Wt�1QA , CI.L- co ,Caw State or County License: If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. DESIGNER 7-f —NID'61—r�.,Oum Narne:'IAYAN�A NE R: Address: x'14 T"YTIblIn Mrip Rc—l' City: Zip: Phone FEESIMPLE TITLE HOLDER: Name: Address: 2-234SE F1OL-T—/\-Nr)— TFREE7� City: Zip. — -- Prione., --- Not Apio-IF6,j-6-1; State: Not Applicable MORTGAGE COMPANY: Name:J AME8 PINDU4.y Not Applicable Address —,,�To 771 —jm,3 L I N ���L�t4 0 city: P01RT"r.wcjF--- Zip: -- -1State: 7�o n — e BONDING COMPANY, Narne:------- Address: Zip, Phone: o Obtain a Permit to do the work anfr staflation as indicated. certify that no worl(or installation has commenced prior to -the Issuance Of a permit, OWNER/ CONTRACTOR AFFIDVIT. Application is hereby made t St. Lucie count' makes no representkition that is granting 1 perrnit: will authodze the permit holder -to build the subject structure which is in con,'Xict witi, any applicable Home Owners Assoclailon rules, bylaws or and covenants that may restrict or prohibit such structure. Please consult with your 1-10me Owners Association and review Your deed for any restrictions which may apply. In consideration Ofthe granting of this requested permi,t, Ida hereby agree,tj)at 1 will, in all respects, Perform -the work in accordance with thea plans, the Florida Building Codes and SC Lucie County Amendments, The 'following building Permit applications are exempt from undergoing a full concurrency review: room additions, accessary structures, swimming pools ic WARNING TO e , �nces, wafts, signs, screen rooms and accessory uWs to another non-resiclent!,�l use OWNER: Your failure to Record a Notice Of COrnme"cament may result in Your P-1ying twice for lrripro�/ernents,t.o Your property, A Notice Of Commencement muni be recorded and Posted on the jobsite before the first cornmE�j� W inspection. If You in -tend to obtain financing, consult with lender or an attorney be -fore )rl( or rec iqg your Notice Of Com me n cc m ent, --Not Applicable ature of owner STATE OF FLORIDA COUNTY OF Y The'f oing in5rrV-?N'nt this izday of as Agent for Owner ure of STATE OF FLORIDA COUNTY OF �dg 'far'e me i"hel7oing ins'Vaqen 2 by this day of --)t0j Name Of perso—n—mt-j-j Personally Known � —V- OR Produced Identification Type of Identification Produced Commission 0"t"'Y Pubfic State (if florkla -!WCqU0Jfn0 A Pasegittk)) MY Coiwr—njision FF 499r's? rupifos Da/22/2()10 REVIEWS FRONT ZONING COUNTER REVIEW I KLCEIVED lcCO` I V1 P I., E T E D Rev, owledgel-lvbefore me S. by Name. ofd IL4, Personally Known Pte�rsq mal , ng, s tatem7ent OR Produced Identification TYPO of Identification Produced J�igna&tLe e( e of Notary Public.- state Of Florida commissIA 1�4 y W -W--w pas(mloifo I MY COMMIS*)I) FF 0,99682 *0 EXPke$ 0/22/2019 E -7 'UPIRVIIO PLANS "VFGETA'7'10'N_R� Sr -A TU RTLE MANGROVE - 1T REVIEW REVIEW REVIEW !w REVIEW a��caRtsr CITY OF PORT SAINT LUCIE BUSINESS TAX RECEIPT 4 SiR1a�' PLEASE POST IN CONSPICIO US PLA CE OR KEEP ON PERSON 'r Term: 10111 2018 -- 91301 2019 Business Address: Business Name: Mailing Address: 2018 -2019 2:344 SE HOLLAND ST ALL FINAL ELECTRIC 2344 SE HOLLAND ST PORT ST LUCIE, FL 34952 Category: Category 3 ELECTRICAL CONTRACTOR Additional Data: BTR#: 123892 ate Mad . 08 912018 % Yk Business Tax. Authority $134.00 Tota] Tax Paid: $134.00 THIS IS A RECEIPT FOR TAX PAID AND IS NOT REGULATORY IN NATURE This receipt does not warrant that the receipt holder is competent to perform in the business, but that the holder has paid the required tax and provided the necessary documentation (if required) for this business. Valid only when all state and local regulated trade licenses/competency cards are valid for the current fiscal year as required by law. i f� O {.i F w qj W U W LLJt� Q wLLI O C) W v Q m z o Z o F- W ON u N LL. CI } ' O Z P<N D N �Q o o V1 Z p Z w—, •� LU LIJa LLI (/n a E Q- c") M < tI f LL IQLL oo O W W�W WQ wj W- u o O� < c -� H +vi°L LL W G1 ° � c F- Z Z Ut z V�0 Oz O J Na v a 00 J U to �] -i a o Z W > © C� Oa 0 ~ M a N LU Ul wry V) w = o �-- Y a '(ALA u hi �,Ilair nl w � 41 , C7. p