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ALL -APPLICABLE INFO MUS
,.COMPLETED FOR APPLtGITiON TO HEA�p
Date -
Permit i n
Permit Number
Buffd ft Permit Application
Planningand Deve%Pment&7Vk r
Building and Oyde Rerun ob tcn
2MV1orniaAvenue, fortPleneF13V82..
Phone. CM) 462-1553 Fax (M)'62"1576 Commercial
Residential
PERMAPPLICATION FOR: To Select from dropbM click
PROP! IMRROVEMENT arI at the end ofDine
LOCATION:
Address: 0Z . EJ . SUE �i Q
Legal Description:
�ATe St,JEET113wu j/,L di'F- 4N�
Property TaxlD#: �yei(o •$03 - GZ - (700- � -
Site Plan Name: " /J 6 x . Lot rim
Project Name: t f r Block no.
Sefbacks Front /_ O '_'Back: Bad Right Side: / 0
1.Leis Side: / O
DETAME00f. CRIPTION OF WORK: _
&A $ao c {•
ap/tadar /Anll� f kN��GRoknt� -,
1 of E C n/n( ECT"
�.V!q� �;KUCTIQN;INFORMiATlOft1: -
.....
HVAC _Gunk Gas Electric _Shutters _ Windows/Doors
Plumbing _Sprinklers _Generator
_
_
_Roof Roof
Total Sq. Pt of Construction:
Sq. Ft of First Floor.
Cost of Construction: $ l
-- _ Utilities: _Sewer _Septic Building Height
I
Company: n% Cow
Orly �L f-1 _V
zipCooe 3�990 State: _ Addr .� I.T.O. . #4 W
Fax City R day
Phone No.
E-Mail: ZP ode: 349� Fax
Phone N,ioi.AV11y�`1.LwTttteFiUInfee5C,w*d'mPaga l�ferent ~Man-
frOrn ^7 eZ 3
E+
the owner fished above) F R r�Asy
Smte or County license:. P5 y trrr:
If valueof ectton la 40 5 or more, a RECORDED Noe ce o7Comrorencement Is required oZ —_
Name'
Address:
Gty: State:
Zip: Phone:
FEE SIMPLE TITLE IfOLDER: —Not Applicable.
Name:
Address:
City:
ZIP: Phone:
Name: 7—
Address:
City: State:
Zip: Phone:
BONDING COMPANY-
Name: —
Address:
Zip: Phone:
Not
OWNER/ CONTRACTOR AFFIDVIT: Application Is hereby made to obtain at permit to do the work and Installation as indicated.
I,certifythat no work or installabon.has commenced prloir to the issuance of a permit
St Lucie Counttflflyy��makes no representation that is l
ssttructure. Pleasecconsult with youcr Home Ownerrs
a subject structure
Act or prohibit such
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 buildingperrnit 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commenrinerWnrie nr rnrnr l:nuvnur AL.+:.... -4:
STATE OF FLORIDA STATE OF FLORIDA
COUNTYOF COLIPMOF��
The forgoing in rumentwas acknowledgeo before me The forgoing instrument was acknowledged before me
this da of 2 ZO by this',a day of DEL MFM _ 20& by
i N�lu UU �t�E�SDtJ _
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public State of Florida) (Signature of Notary
/Public- State of Florida)
Personally Known OR Produced Identification Personally Known L OR Produced Identification
Type of Identification Pro ype of Identification Prodi
"" lrdll
e'' """' BRITTANY REDDIN
Commission Nc. k Ste of sion -Notary Pu 2i ommission No. �`�' P�B`ti3 Stat orida-Notary Pub
_ C �sion f! GG 190182 y
My Commission Expires „� �i;g Cohim sion#GG19028:
PLANS
REVIEWS. I
FRONT ZONING COUNTER I REVIEW I SUPERVISOR REVIEW I REVIEW
VEGETATION I SEATURTLE I MANGROVE
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