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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:Y - _19 Permit Number:A M9
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RECEIVED
Building Permit Application
Planning and Development Services OCT 2 9 2018
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 ST. Lucie Cou ty, Permitting
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Resi entla
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line ri
EPJM ROVEME-IVT LO:CATION� 4
Address: Q 3 UM—19-V
Legal Description:
Property Tax ID#: I LI AUL 7 0/' QJLdcz- 000-a Lot No. �3V
Site Plan Name: Block No. a
Project Name: .
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK 4 xe
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CONSTRUCTION INFORIV�ATIO,IV
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Additionalwork toe nertormed under this permit-check all appy:
❑HVAC Gas Tank DGas Pi _ (�Windows/Doors
— Piping Shutters l�
Electric 0 Plumbing F]Sprinklers FIGenerator g Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ S� Utilities:Sewer ElSeptic Building Height:
OWNER%LESS,EE NTRACTOR:
Name _JCxv%%es Name: ARTHUR ENGELMANN
Address: 123 Clurev� �Irw� Gl Company: ACCURATE ELECTRICAL CONTRACTING, INC
City: I-tc.+01 ,,x cvti I State: If-I Address: 7193 GULLOTTI PLACE
Zip Code: 14 q Fax: City: PORT ST.LUCIE State:FL
Phone No. Zip Code: 34952 Fax:
E-Mail: Phone No. 772-878-9171
Fill in fee simple Title Holder on next page(if different E-Mail: ACCURATEELECTRICPSL@OUTLOOK.COM
from the Owner listed above) State or County License*.EC0003072
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:ARTHUR ENGELMANN
Address: Address:
City: State: City: PORT 3T.LUCRE State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:7+93 GULLOTn PLACE 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.
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 fig t inspecti9p, If you intend to obtain financing, consult ith lender or an attorney before
'
commen work or rdin our Notice of Commencement.
Signa re of Own /Lessee/Contractor as Agent for Owner Signature of Cont r ctor/License Holder
STATE OF FL RIDA ����� STATE OFF IDA
COUNTY OF COUNTY OF
The forgoing instrumen wa acknowledged before me The forgoing instrument s cnowledged before me
this�day of 20ZZ_by this /b day of 01f> 20 r by
Name of person ry&ing statement Name of person ma mg statement
Personally KnownAOR Produced Identification Personally Known��OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Public-S ate\���p���j/ (Signature of Notary Public-Sta o\ /Zi
Commission No. Commission No.
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REVIEWS FRONTS6:JoI t�o7 SUPE 1SOR PLANS VEGETATION l3#E' UR y ,11I AVE
COUNTED 'F �rN �:,1 $ EW REVIEW REVIEW cnded� ►/
DATE
RECEIVED /g/�el��STAtEO
DATE
COMPLETED `
Rev.8/2/17