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MI APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED f
Date: 3'-' 5---1.C Permit Number: I v_ �---.
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missimanommmir Building Permit Application
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Planning and Development Seivices and Code Regulation Division St'Cu e County ent
Building
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPE:Demolition
PROPOSED IMPROVEMENT LOCATION:
Address: 24909 Orange Avenue, Fort Pierce, Florida 34945
Property Tax ID#: 2112-441-0003-000-6 Lot No.
Site Plan Name: 24909 Orange Avenue Block No.
Project Name: 24909 Orange Avenue
DETAILED DESCRIPTION OF WORK:
Complete demolition
CONSTRUCTION INFORMATION:
Additional work to be performed 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: Sq. Ft.of First Floor: ,�
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Cost of Construction:$ '2‘4 �' T & Utilities: _Sewer _Septic Building Height:
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OWNER/LESSEE: CONTRACTOR:
NameScott S. Crippen & Lindsey A. Crippen Name:C.G.Taylor j
Address:16 Castle Court Company:L.E.B.Demolition&Consulting Contractors, Inc.
City: Hutchinson Island, Florida State:_ Address:7 Harbour Isle Drive East 204
Zip Code: 34945 Fax: City: Fort Pierce State:FL'
Phone No. Zip Code: 34949 Fax: 772-461-2225
E-Mail: 1 Phone No Office 772-461-4545/772-216-1286 1
aol.com
Fill in fee simple Title Holder on next page(if different E-Mail iwreckn@aol.com
from the Owner listed above) State or County LicenseCGC1519945/27215
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x 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: 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAI FINANCING, CONSULT
WITH YOUR LENDER OR IY ATT1NEY BEFORE RECORDING YOUR NOTICE OMM MENT."
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Signature of Owner/Lessee/Contractor as 4gent for Owner Signature of Contractor/License Ho r
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFsanttucie COUNTY OFsaintLicia
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 1st day of February ,2019 by this 1st day of February ,20' 19 by
C.G. Taylor C.G. Taylor
Name of person making statement. Name of person making statement. ti
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Personally Known xX OR Produced Identification Personally Known xx OR Produced Identification
Type of Identification Type of Identification
Pr duced • • ced
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ignature of Notary Public-Stat\ _• BEC�Fii��� (Signature of Notary Public-Sta\��i f,Q�,• l'ED,.",4
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Commission No. GG 083308 a -,..c,,,' w" 6§,po ;� Commission No. 00083308 V• cp ail* �O
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• #GG 083308 _ _T. #GG 083308 •
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RECEIVED DATE /// /��� I I11 STA
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DATE
COMPLETED
1ev.2/7/19
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