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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED D
Date: Permit Number:
R E
Building Permit Applic tion SAY 2 2ot9
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial R Si nl i�jc'e County, FL
PERMIT TYPE:DRIVEWAY
PRQPOSED IMPROVEMENT LOCATION;„
Address: 7508 Donlon Rd Fort Pierce, FL 34951-1742
Property Tax ID#: 1302-810-0098-000/0 Lot No.23
Site Plan Name: Block No.
Project Name: DRIVEWAY
DETAILED DESCRIPTION OF-WORK
REMOVE AND REPLACE EXISTING CONCRETE 13'WIDE DRIVEWAY WITH NEW CONCRETE DRIVEWAY AT 16'WIDE
o C Gt'�•� S t
10- L4_9 e' l=d'D M cel 1't r.l VJ r/`p h f elka D I
CONSTRUCTION"INFORMATIOW,
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: 4 Sq. Ft. of First Floor:
Cost of Construction:$ $6300 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE CONTRACTOR:
Name U f-S<p o cJ c G Name:
Address: 7S_0 1r" 6c)-1aA Company:
City: r�. Pt`C`�`C, State: Address:
Zip Code: Sr Fax: City: State:
Phone No. Zip Code: Fax:
E-Mail: Phone No
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License
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.
SUPPLEMENTAL,CONSTRUCTION,LIEN LAW INFORMATION
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: 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 OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of O er/Lessee actor as Agen Signature of ntractor License olderIc-al"
•o
STATE O FLORID ,,, STATE OF FLORID COUNTYOF COUNTY OF
ocThe forgoing instrument was acknowledged bef — The forgoing instrument was acknowledgthis day of .. 20 b �, this�day of 208 Name of person making sta ment. Name of person making statement.
Personally Known OR Produced Identi io Personally Known_�OR Producedty
Type of Identification Type of Identification
Produced Produced
(Signature of No r Public-State of Florida) (Signature of Notary liC State o F orida)
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
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