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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
W
A f
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYRE: Electric
PROPOSED IMPROVEMENT LOCATION:
Address: 5281 TREETOP TRL
Property Tax ID #: 1407-343-0005-000-1
Site Plan Name: Tree Top Trail
Project Name: Tree Top Trail
DETAILED DESCRIPTION OF WORK:
TEMP POWER POLE INSTALL
I CONSTRUCTION INFORMATION:
Permit Number:
Building Permit Application
Commercial Residential X
Additional work to be performed under this permit —check all that apply:
_Mechanical — Gas Tank _ Gas Piping Shutters
Electric _ Plumbing Sprinklers Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:_
171
Lot No.
Block No.
Windows/Doors
Roof Pitch
Cost of Construction: $ Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameJohn D Sweeney
Name: Donald B Green
Company: Don Green Electric LLC
Address:8165 103rd AVE
City: Vero Beach State: 4--,
Address: 1305 W 1st Street
Zip Code: 32967 Fax:
City: Fort Pierce State: EL
Phone No.
Zip Code: 34982 Fax:
Phone No772-418-5739
E-Mail:
Fill in fee simple Title Holder on next page ( if different
E-Mail dongreenelectric@gmail.com
from the Owner listed above)
State or County License EC13007447
IT vague of construction is :�Zsuu or more, a RECURDE0 Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: I I
DESIGNER/ENGINEER: Not Applicable
Name:
Address:
City; State
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and inscauauon as inaicateu.
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, 1 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
WIT YOUR LENDER OR AN ATTORNEY BEFORE RECORDING Y U 114t Ur l.UMMEM 6cmrm I
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA j STATE OF FLORIDA
COUNTY OF N COUNTY OF- k&--rod
The fo oing instrugi=t was acknowledged before me The ing instrume s cknowledge4fore me
this day of 26 by this ay of 20_ Y
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
- -I A
(fignalure of Notary Pu IT.- StO, of Florida (SfMt1ire of Notary
Joy Christine Copetend L My Commw4m GG 937752
Commission No. My Co GG 937752 Commission No. a Expires 0t M
a
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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