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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number)-5)( 0 " -Wo
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Building Permit Applicatiom? 3
anning and Development Services
Biuiiding and Code Regulation Division perm�tt\_Ucie 9 Ca went
St.
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
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PERMITTYPE: Demolition Permit
PROPOSED IMPROVEMENT LOCATION,:
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Address: 10725 S Ocean Dr 452, Jensen Beach, FL 34957
Property Tax ID#: 4511-502-0102-000-7 Lot No.14
Site Plan Name: Holiday Out at St Lucie SEC B Block No. P
Project Name: Dubois Residence
DETAILED DESCRIPTION O'F WORK:
Demolish Existing Structure
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CONSTRUCTION INFORMATION:
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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
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Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ ` IL1 q q• p1 Utilities: _Sewer _Septic Building Height:
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OWNER/LESSEE, CONTRACTOR; „
Name Mariella & Frederico Dubois Name:Robert Cenk
Address:8652 Tourmaline Blvd Com pa ny:Homecrete Homes Inc
City: Boyton Beach FL. State:_ Address:2162 NW Reserve Park Trace
Zip Code: 33472 Fax: City: Port St Lucie State:FL
Phone No.561-809-6984 Zip Code: 34986 Fax: 772-873-6686
E-Mail:dubois_fj@yahoo.com Phone N0772-873-6707
Fill in fee simple Title Holder on next page(if different E-Mail bcenk@homecretehomes.com
from the Owner listed above) State or County LicenseCGCO62378
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 CO.NSTRUCTI;ON LIEN,.LAW INFORMATION l
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name:Braden B Braden AIA PA N a m e:NA
Address:4`17 SE Coconut Ave Address:
City: Stuart State: FL City: State: 1
Zip: 34995 Phone772.287-8258 Zip: Phone:
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FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name:NA Name:NA
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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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. 1
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 NOTIQ OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTIO . F YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDIN OU NO 1 E jpF COMMENCEMENT." i
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Signature of Own r/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
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STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Ir L'�je,i COUNTY OFA'[ LS.JP i Q�
The forgoing instrument was ack owledged before me The for oing instrument was acknowledged before me
this qday of �f�,ft 20A by thisp ay of Q_m� D✓ 20� by
IYAQ 61&4 Do Boi-s
Name of person making statement. Name of person making statement.
Personally Known OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identi ication Type of Identification
Produced L t,CZvSIL, Produced
(Signature of Notary Public-State of Florida ) (Signature of Notary P blit-State of or )
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Commission No. l�-tr®� '5b / (Seal) Commission No,C1QF C2y q
olNotary PubliSh�of anlori
ry Public on
My GG 28448
REVIEWS FRONT Z lyI P %UMPA, VEGETATION S AVE*"�AI��V
COUNTER R V Expi"Wo22 REVIE REVIEW
DATE
RECEIVED ,
DATE
COMPLETED
Rev. 2/7/19
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