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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ,. I-19— g Permit Number: Ib1Rr ®K
I:CEIVED
C ,,s4 -ii,,- -._.:....7'..,Q *- r, . vNOV 1}9 701e
Building Permit Application Permitting�ep�rtment
Planning and Development Services SC,6y�!eaNt1t ;i
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED, 1w!rROVEMENT LOCATION,'
Address: 3104 AVENUE S, FORT PIERCE, FL
Legal Description: SUNRISE PARK NO 1 BLK 2 LOT 20 (0.17 AC) (OR 4095-2853)
Property Tax ID#: 2405-501-0045-000-4 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
f.. :
s
DETAILED DESCRIPTION OF WORK, r
RE-ROOFING:
-DRY-IN:TRIBUILT PEEL AND STICK
-TAMKO ROOF SHINGLES
CONSTRUCTION INFORMATION
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Y
Addnnitional work to be performed under this permit—check iall that,apply:
T]HVAC _Gas Tank Gas Piping _Shutters [J.Windows/Doors
I I Electric ❑ Plumbing Sprinklers _Generator _Roof 3:12 Roof pitch
Total Sq. Ft of Construction: 1925 S . Ft.of First Floor: 1925
Cost of Construction:$ 13500 Utilities: _Sewer _Septic Building Height: 9.0 FT
OWNER%LESSEE rCONTRACTOR
Name MAXIPLEX, LLC Name: ALBERTO MUNOZ
Address:5475 NW SAINT JAMES, DR. #407 Company: CONFORT BUILDERS, LLC
City: PORT ST. LUCIEState:F� Address: 393 NW STRATFORD LN.
Zip Code: 34983 Fax: City: PORT ST LUCIE, State:FL
Phone No. Zip Code: 34983 Fax:
E-Mail: Phone No. 772 224 9110
Fill in fee simple Title Holder on next page(if different E-Mail: COBUILDERS15@YAHOO.COM
from the Owner listed above) State or County License: CCC1328737
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATIQN
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable�1
Name: Name: ,I
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address:393 NW STRATFORD LN. 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 represu
sentation that is granting a permit will authorize the permit holder to build thesubject 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 your Notice of Commencement. I
/f/,✓ r ,
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Signature of Owne /Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE COUNTOF Y OF ORIDh7l L-U. CA Q COUNTSTATE Y OF F FLORIDA S\— L & c 1 i
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The forgoing instrument w s acknowledged before me The forgoing instrument was acknowledged before me
this /fday of C:)✓ ,20 tJ by this /lay of A)
Q✓ ,20_7S–by
a.t�.. r �Xn c02 J-U .),-1 )‘Il UE,—
Name
Z _Name of person making statement Name of person making statement
Personally Known OR Produced Identification Personally Known . OR Produced Identification
Type of Identification Type of Identification
Produced c- PL_ Produced __ 0(--
ejtjAICCUr _
Fo,,,u,,,e--
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_.,�y,", �,'bf Lublic GHN( g r, � rc-st����1b�fSi natur ���- Si nature of M1 oa�� '(�J'r° °0_State of Florida-Notary Public
* *_ Commission0 9 - "l-* *_ Commission # G2, 0079
CommissVr.:C=ili My CommiCommission N5. ;�i-i1"!4S „ ommissi �,E�iiies'"�`F��rOctobe ' i,ii `
" "` '� " October 22, 2022
II
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17