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PERMJTNUMBER: OUIO 'C:(yjLl
CERT. CAP. NO.:
DATE FILED: : if · ~ .()/)
PLAN REVIEW FEE: [CC>· ð7:J
CONCURRENCY FEE:
RECEIPT NO.:
RECEIPT NO.:
S~%
ALL INFO MUST BE COMPLETE & FILLED IN TO BE ACCEPTED
. ~:'. :£1.
St. Lucie county.~u..ilding an,d z.-..;~.~ ." f~ C"· 0, P·· Y··
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772-462-] 553
APPLICATION for BUILDING PERMIT
CERTIFICATE of CAP ACITY/ZONING COMPLIANCE
PROJECT INFORMATION
].
2.
3.
4.
LOCATION/SlTEADDRESS: 5:>-7 ;ÞJSt- LvAY J FiJ Plé~ F-¿ S??YS-
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SID NAME: SITE PLAN NAME: .
PROPERTYTAXID#: c?~J" (peJl ~ (){)'5/P · Ctl:J. 3
LEGAL DESCRIPTION (attach extra sheets ¡fnecessary):
5.
PLAT
BOOK
6. PAGE
NO.
7. BLOCK
NO.
8. LOT
NO.
9.
PARCEL SIZE: ACRESISQ FT.
LOT DIMENSIONS
10. DESCRIPTION OF CONSTRUCTION PROJECT OR WORK ACTIVITY:
£ ~ rL.t-l £) O^-Î €) ,J ì/-'fJ .6 E t C-þ ~ ¡,. 't:.
] ).
SETBACKS (ACTUAL) FRONT:
BACK:
RIGHT:
SIDE
LEFT:
SIDE
]2.
TYPE OF CONSTRUCTION (Check all appropriate boxes)
[] NEW CONSTRUCfION X EXPANSION/ADDmON
[] RESIDENTIAL [] COMMERCIAL
[J OTHER (SPECIFY)
13. DESCRIPTION OF PROPOSED USE: )..J.'~ V)ug£ A jI .(>-!ftr!-AJIJ'£¡V) ~~)..b~µCE.
[] INTERIOR RENOVATION
(] INDUSTRIAL
14. Sq. FtJCONSTRUCTION: 15. Sq. Ft. 1st Floor:
JF
16. VALUE OF CONSTRUCfION: $ ~..J 00 tf). 0 0
The value of construction is used to determine the amount of permit fees to be assessed. Sl Lucie County reserves the right to question and/or modify the indicated
value of construction jf it is demonstJated that the submitted figures arc not consistent with similar types of construction activities. If the value is $2500 or more, a
RECORDED Notice of Commencement must be submiäed with this application.
SLCCDV Form No.: 001-02
OWNER INFORMATION
NAME: 'TI9 M ¿ A f/,J 0 (t-J)
ADDRESS: ,~ d- '7 þ.\1 J..t:., W ,4-1
CITY: p~ P/~Cr: STATE: ·FL ZIP' .s~J~\ç-
PHONE (DAYTIME): <f@. :;40· q L{'ð (¡; emai1:
IF THE FEE SIMPLE TITLEHOLDER (pROPERTY OWNER) IS DlFFERÊNT FROM THE OWNER LISTED ABOVE, PLEASE
FILL IN NAME AND ADDRESS BELOW.
FEE SIMPLE TITLEHOLpER:
ADDRESS:
CITY : STATE: ZIP
PHONE (DAYTIME): L-.)
CONTRACTOR INFORMATION
ST. o"fFL REGJCERT #:
BUSINESS NAME:
QUALIFIERS NAME:
ADDRESS:
CITY :
PHONE (DAYTIME): L-.)
ST. LUCIE COUNTY CERT #:
STATE: ZIP
FAX NO. emaj):
ARCHITIENGJNEER:'J~~I:>¿¡../ 1 i.,~~ A..I.. A p~ ,4,.
~
ADDRESS: ~, .,. Cor{)#.J1 A-d£ ~
CITY: ST'v',4Ct--r. STATE: F L ZIP
PHONE(DAYTIME):(7'~ .l.~7-gà-~
],'1~?/;
BONDING C<?MP~:
ADDRESS:
C1TY :
STATE:
ZIP
MORTGAGE LENDER:
ADDRESS:
CITY :
STATE:
ZIP
IMPORT ANT NOTICE: When a permit is issued and it is not picked up within 60 days after notification
it will be voided and returned to you by mail. ' .
CERTIFICATION:
This application is hereby made to obtain a permit to do the work and installations as indicated7 and to obtain a certificate of capacity,
if appJicable7 for the permitted work. I certify that no work or installation has commenced prior to the issuance of a permit and that all
work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that separate permits
may be required for ELECTRICAL, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS,
AND AIR CONDITIONERS, ETC., not otherwise included with this building permit application.
The -following building permit applications are exempt ftom undergoing a full concürrency review: room additions, accessory
structures (all· types), swimming pools, fences, walls, signs, screen roolDS, utility substations & accessory u~es to another non-
residential use. . .
NOTICE TO OWNER:
FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR
PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO
OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE
RECORDING YOUR NOTICE-OF-COMMENCEMENT.
NOTICE TO APPLlëANT:
AS TIlE APPLICANT FOR TIllS BUILDING PERMIT, IF IT IS NOT YOUR RIGHT. TITLE.
AND INTEREST THAT IS SUBJECT TO ATI ACHMENT: AS A CONDmON OF TIllS
PERMIT YOU PROMISE IN GOOD FAITH TO .DELIVER A COpy OF THE ATI ACHED
CONSTRUcnON LIEN LAW NOTICE TO THE PERSON WHOSE PROPERTY IS SUBJECT
TO ATIACHMENT.
OWNER'S AFFIDAVIT:
I certify that all the foregoing information is accurate and that an work wiJI be done in com iance
with all applicable laws reg~lating construction and zoning.
CONTRACTOR SIGNATURE
STATE OF FLORID~. ~' _ , I. '
COUNTY OF ,L. J.-U UJ2
STATE OF FLORIDA
COUNTY OF
The fOregOin~· rtrument ~_. acknowle~ed
~re me~ d~y of ) 20Jijby
, rn ' !) . w ,~is personally
~wn to me or wfí?h~
t2fo'7 ð ( Z · L{" · entification.
The foregoing instrum t was -acknowledged·
before me this _ y of , 20 -' by
, who is personally
known to me or ho has produced
as identification.
Signa e of Notary
Signature fNotary
~.~ x-z,G-v~(ÐcUtt-
Type or Print Name 0 otary l\~.f~~: PUBUC-~TATE OF FLORIDA
~~~~ Beatnz Goycochea
- , ~ ..
Commission NO.d . . (SeåJ~~ " ) ~orr;~~:sion # DDS89694
I" '1\\'" L..Jxpirt~. JULY 01, 2007
BO~DED THRC AILP":\;TIC BONDING CO'J INC.
T e or Prin~ Name of Notary
Commission No. (Seal)
NOTE: TWO (2) SIGNATURES ARE REQUIRED. EACH SIGNATURE MUST BE NOTARIZED. IF APPLYING FOR
THIS BUILING PERMIT AS AN OWNERlBUILDER, TIlE OWNER MUST PERSONALLY APPEAR TO SIG~
THIS APPLICATION IN. THE OFFICE LISTED ON THE FRONT OF THE APPLICATION.
For specific instructions see appropriate permit checklist.
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Code Compliance Division
2300 Virginia Avenue
Ft. Pierce, FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1148
http://stl ucieco. gOY / ce
BUILDING PERMIT
Page
Issued: 11/20/2006
Job Location: 527 DUSK WAY
Permit Type: Building (Miscellaneous)
Job Description: CONSTRUCTION OF A SHED/GARAGE
Subdiv: Tropical Acres
Lot: 56 Block:
Conf #: 729
Permit #: SLC- 061 0-0056
City: FORT PIERCE
Parcel: 2308-601-0056-000/3
Property Owner
TOM L FORD
527 DUSK WAY
(772) 465-3083
FORT PIERCE, FL
Setbacks Left:
Number of Units: 1.00
Minimum Floor Elevation:
Right:
Floors:
Front: 58.00 Rear: Zoning: AG-2.5
Buildings: Square Footage: 498.00
Flood Map: 175F Flood Zone: X Elev:
Job Value: $ 21,772.56
Permit holder acknowledges through acceptance of this permit that separate permits must be obtained as required by the Florida Building Code
including those for all electric, plumbing, mechanical, roofing, and structural work. Further, he/she acknowledges responsibility to comply with all
requirements of the 2004 Florida Building Code.
NOTICE: In addition to the requirements in this permit, there may be additional restrictions applicable to this property that may be found in the
records of this County, and there may be additional permits required from other governmental entities such as water management districts, state
agencies, or federal agencies. s:553.79(10), F.S.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR
BUILDING IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN
ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. s.713.135, F.S.
Ray Wazny
Building Official
Date
For Automated Inspections, Call (772) 462-1261
For Questions, Call (772) 462-2172
St. Lucie County Land Development Code Section 11.05.01 (A) (2) states; Building Permits shall expire and
become null and void if work authorized by such Building Permit is not commenced, having called for and
received a satisfactory inspection, within six (6) months from the date of issuänce of the permit, or if the work
is not completed within 18 months (permit by contractor) or 24 months (permit by owner) from the date of
issuance of the Building Permit.