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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Building Permit Application
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Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPE:Electric
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Address: 3807 S Avenue S Ft. Pierce, FL 34947
Property Tax ID#: 2405-601-0124-000-9 Lot No.
Site Plan Name: Block No.
Project Name: Andrews
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Install 120V 20AMP Dedicated GFCI circuit
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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:
Cost of Construction:$ 700.00 Utilities: —Sewer _Septic Building Height:
9/00"//1",
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NameJames Andrews Name:Walter Nasi
Address:3807 S Avenue S Company:Sol Electric LLC
City: Ft. Pierce State:_ Address:5500 SW 43rd Ter
Zip Code: 34947 Fax: City: Ft. Lauderdale, State:FL
Phone No.772-465-1574 Zip Code: 33314 Fax:
E-Mail: Phone No 754-423-4105
Fill in fee simple Title Holder on next page(if different E-Mailwnasi72@Yahoo.com
from the Owner listed above) State or County License EC 1300 8044
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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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&XNDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Sig ature of Owner/Lessee/Contractor as Agent for Owner Sign ture f Contractor/License Holder
STATE OF FL COUNTY O �6 STATE OF FLO�JD� MI—A
COUNTY OF.
The f;W ing instru t was ac nowledgeAbefore me The f ing instru as acknowledged efore me
thiso- day of 20(yby thi day of 20-Hby
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Kn R Produced Identification
Type of Ident' ' Type of Id tification
Produced [i Produced /
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( ignatu o tar f l rida) Signature f a b i - t I JI
,0n tary Public State of Florida
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Commissio o. THRYIW� - Commission N .c . 4 mission- ®4�2
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REVIEWS FRONT ZONING S U Pr`X4 R PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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