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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: \ ay `Q-d Permit Number:
T
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITTYPE: S V_
Addres .
C*'� „�%V RECEIVED
Building Permit Application JAN 2 4 2020
ST. Lucie County, Permitting
Commercial Residential X
Property Tax ID q: 3414-501-0701-000-2 (St Lucie Gardens 23 36 40 BLK 3 N 112 of Lot 1) Lot No. �-
Site Plan Name: Block No. 3 N �/Z
Project Name: %hL 9_e.f)ic,er`r_A-
I, DETAILED DESCRIPTIONOF WORK:
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
XMechanical xGas Tank Aas Piping _Shutters
XElectric XPlumbing _Sprinklers _Generator
Total Sq. Ft of Construction: U 123
Cost of Construction: 60
—Windows/Doors
Roof Pitch
Sq. Ft. of First Floor: 1-A\23
Utilities: ewer Yseptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
NameChad Hinkle
Name: Don Hinkle
Address:5717 Tangelo Drive
Company: Don Hinkle Construction Inc.
City: Fort Pierce I State: F(
Zip Code: 34982 Fax:
Phone No'772-528-2227
Address:219 Hunt Ave.
City: Fort Pierce State: FL
Zip Code: 34946 Fax: 772-467-1348
Phone N0772-528-2249
E-Mail: chadhinkle@bellsouth.net
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Maildonhinkle@bellsouth.net
State or County License CGC 036040
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
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 LENDER OR AN ATIORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT:"
Signature of Owner/ essee/Contractor as gent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTYOF -1-I,�c�r
STATE OF FLORID
�;—�e—
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this,230hayof20�-oby
this�day of20,oby
Name of person making statement,
Name of person making statement.
Personally Known ✓ OR Produced Identification
Personally Known r/ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
( na ure of Notary Public -State of Flori"`°Ym ;,.:•'
(Signature of Notary Public- State of Florida)
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Commission No. %G a ll �t'2 0 (� o
Commission NoE Ai 1(Se
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DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19