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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: May 26th, 2020 Permit Number: P005 ` oe(
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Building Permit Application JUN o 3 2020
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Planning and Development Services , _,�i • ":�.?:I��;� "_%''.._`,=.. ' `r•'""l
Building and Code Regulation Division Commercial kesi.dentia;l•X+ � _-F
2300 Virginia Avenue,Fort Pierce FL 34982 -- --- -- - - -- -- --�
Phone:(772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR: Denise Gonzalez
?ROP C►SED 111%1'PROVEMENT'LOCATlON
Address: 4680 Sunrise Blvd. Fort Pierce FI 34986
Property Tax ID#: 3404-501-0181-000-9 Lot No.10,11,12,13
Site Plan Name: Gonzalez 14,15,16,
Project Name: Gonzalez 1 S`p�b 17,18
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DETAILED DESCRIPTION OF WORK
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CONSTRUCTION INF.ORM'ATION /
Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank —Gas Piping _Shutters _Windows/Doors _Pond
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ Utilities: _Sewer _Septic Building Height:
__"OWNER/LESSEECOIVTRACl-OR
Name Denise Gonzalez Name:
Address:4680 Sunrise Blvd Company:
City: Fort Pierce State:P II Address:
Zip Code: 34982 Fax: City: State:
Phone No.305 588 9343 Zip Code: Fax:
E-Mail: dbrl8Qhotmail.com Phone No
Fill in fee simple Title Holder on next page(if different E-Mail
from he Owner listed above) State or County License
f. 71 e i zr b t re c,T To
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
If value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION f
DESIGNER/ENGINEER: _Not Applicable' MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLEHOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attor efore commencin work or recording our Notice of Commencement.
Sig re of Owner/L ssee Co ractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA (��, STATE OF FLORIDA
COUNTY OF cJ COUNTY OF
Swor to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
✓ Physical Presence or Online Notarization Physical Presence or Online Notarization
this,,2-9 day of 'MAvlX .2020 by this day of 2020 by
n ZQ,1 0'7-
Name of person makin tement. Name of person making statement.
Personally Known OR Produced Identification °� Personally Known OR Produced Identification
Type of Identification l Type of Identification
Produced Cl Y'- C- Produced
(Signature of Notary P lic-State (Signature of Notary Public-State of Florida)
Y , DREY B.HUMP"
? `" ION#GG 300817
Commission No. _ P ONlarch6,2023 Commission No. (Seal)
*' �=
EXPIRES'- tars
'T o°' nded-thruNotary PubticUnderxa
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REVIEWS FRON ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER- REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.5/6/20