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Permit Nu
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Alan�ing O'nt�Devela Bu-r'1din
&r!lding and Cade Re rnent5ervfces g Permit Application
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Phone: • Fort Alerce FL 349S2
�77z} a53 Fax: .
(772) 462,�579 Commercial
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site Plan Name: C� 7
Project Name:
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Total Sq. Ft of Canstructio +-..JSprinklers Windows/Doors
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Cost of Construction: $ �l5 5 C] Roof
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Sel7tic Name B1+Ildfng Lief ht: CO
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Address:ACT'O',
Si{�1/1biZp� f?� Name• 0
City: T..� It�f L� Y, �`� I ��i}
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Zip Code: �7 State: t' '�� �� , e eel-(.gi'o �
Phone f�o� Fax: Address: .5C �titcj
F-Mail:
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Phone No, l7^ Fax: 17� `7�- t%�1v3
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if value o EfltistruCtfOr} 15 $2500 or mp State or County License: C ; Ul
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re, a RkORDED Notim ❑f C❑
mmentement is required. li!
Name: -._.
Address:
City: State'
Zip: Phone•
MORTGAGE COMPANY:
Name:
Address.
Not Applicable
City:. State;
Zip: _ _ Phone:
FEE SIMPLE TITLE HOLDER: � Not Applicable BONDING COMPANY; Not Applicable
Name: Name: __
Address: Address:
City: city:
Zip: Phone Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit,
5t. Lucie county makes no representation that is granting a permit will authorize the permit holder to build the subject strucl:ure
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 first In action. If you intend to obtain financing, consu attorney before
co enci r or recor I ur Notice of Commencem
_ Slgriature'of:Owner/ Lessee/Agent -� m , , .Signature of Conti orlLlcense HolderSTATE OF S.
COUNTY OF�A -9
9Zo;
r o
The forgoing Instrument was acknowledged beforerr o 9 tp
this day of r . 20 aby � � �
r- ''4
(Namepf person acknowlediaina 1 n
ature of Noit ry Public- state of
Personally Known :��OR Produced identification
Type of identification Produced
Commission No.. `� �. � (Seal)
Revised 07/15/2014
REVIEWS I FRONT ZONING SUPERVISO
COUNTER I REVIEW REVIEW
COMPLETE
INITIALS
STATE OF FLOR
COUNTY OF .- ;;a
��aar
The forgoing instrument was acknowledged beforeI
this day of 20 b
y V Sf 2
Im
(Name ofpdrson acknowledging
of Nt tary Public- State of Florida
Personally Known x✓ R Produced identification
Type of identification Produced
Commission No. (Seal)
R
PLANS
REVIEW
VEGETATION
SEATURTLE
MANGROVE:
REVIEW
REVIEW
REVIEW