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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:- A \ a.\\A_ Permit Number:
!RECEIVED
J JUL
22
UL 2 2 201,9
Building Permit Apple 00 County,permitting
Planning and Development Services
Building and Cade Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT TYPE'�00 - •�
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Address: V-1LA ('x Ll -d 5
Property Tax ID#: ,�- �JC�(' (�(��� ` Z ?(� - C� Lot No. 7
Site Pian Name: Block No.
Project Name: S O
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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 X Roof 1 Pitch
Total Sq. Ft of Construction: bHOA 3 Sq. Ft.of First Floor:
Cost of Construction:$ 3rJ�000 vtJ Utilities: � Sewer —Septic Building Height:
Name 4- Name: 1/!n k'&1'.5 Y S
Address: Company:
City:t r�� S
State: Address: R� 1C/�' —71-11-6yo P�
Zip Code:3'—f g '7s(p Fax: City: ='nSGState , /
Phone No.-1-1 a" �i6`6a," q`1�'-� Zip Code:_S4196-11 , -7 Fax:`�a- `-w- /'OFFS/
E-Mail,:---- Phone No Y` 1000
Fill in fee simple_Titie Holder on next page(if different E-Mail e'JC. •Gb Jtil
from the Owner listed above) State or County License a
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.
x
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 thepermit 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 ORE RECORDING YOUR N E OF COM EMENT."
Sign re of Owner/Lessee/Contracto or per Sign re of Contractor/Li ense H91der
STATE OF FLORIDA//, ,,: STATE OF FLORIDA
COUNTY OF __ J COUNTY OF �w>/-/n)
The forgoing instrument was acknowledged before me The forgoing instrum=1 was acknowledged before me
this 1'7 day of 20/? byl this /7/day of l '4 � f 20- by
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 Produced
t1)
ignature of Notary P ic-State of Florida) (Signature of Notar ub -�,,ts+t f Florida}
Commission No. `! S nNotadraJ�terifiy Commission No. +[' Sandi ocFlora,
Commission GG 288697
G►::O'mlasfon GG 296597 iia ExPI misai 21123
REVIEWS FRONT ZONING %SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.