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All APPLICABLE I FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: / Oza Permit Number:.' -ad � -ts 51
11041ILMUL8 10 0 1 RECEIVED
- —_- -- Building Permit Applica ion
Planning and Development services JAN 2 9 �rj2Q
Building and Code Regulation Division ST. Lucie County, Perrr
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMITTYPE: L4Y
Address:
Property Tax ID It: Lot No.
Site Plan Name: -F / Block No.
Project Name: ,i t2etw csl7P�
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: E340
Cost of Construction: $ ?q'7'7' V-
Sq. Ft. of First Floor:
Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEEt
CONTRACTOR:
Name e i Iro
Name:
Address: 67C L41-w /;L-
Company: .SU-&elLlo/Z r5/ ro &1
City: P T & e/Le(2 State: EL
Zip Code: Fax:
Phone No. %7Z - .?32 5 C9
Address:: 6/ 6S- .S C/, 5 /114,y
City: Ir-%-8J e24'�P— Stater
Zip Code: 11L182 Fax:
Phone No '%7Z-yG0"'4A 5;
E-Mail: p�Df� N Ve/ iwCJ
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail
State or County License
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.
UPPL -MENiT L GGN
DESIGNER/ENGINEER:
Name:
UCTIO LI N IMMION:
_ Not Applicable
MORTGAGE COMPANY: _.Not Applicable
Name:
Address:
Address:
City:
Zip: Phone
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OW NEK/ CONTRA RA(,1 OR Ahh1UV I 1 : 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 thesubject structure
which is in conflict with any applicable Home Owners Association rules, bylaws orand.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 l 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 nbn'-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 ATTORNEY BEFORE RECORDING YOUR NOTIGE'OF:COMMENCEMENT "
ignatur of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Sa-_ Leo\
COUNTY OF
The forgoing insgWnent was acknowled 0 before me
The forgoing instrument was acknowledged before me
this Z� day of , WN 20by
this _ day of 20 by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known -OR Produced Identification
Type of Identific n
ToA
Type of Identification -
Produced )D L-
Produced
(Signature of Notary blic-State of Florida
(Signature of Notary Public -State of Florida) .
e g� N # GG 022020. GIvIENS..
Commission No.tc L.4.' ,5 D
- .
Commission No. (Seal),
s MY 00- • 2020
FXPIRES:December 56,
74'"--". pubLcUnde�writeis
REVIEWS.
FR m.IV
G ;"
SUPERVISOR PLANS.
-VEGETATION
.SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. Z///19