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Building Permit Application
All APPLICABLE INFO MUST BE CO'..r•',ETED FOR APPLICATION TO BE ACCEPT-•. II 2f�I Q I ©3 Date: ta' ��' \ Permit Number: l I I �G� V� Aft VES Building Permit ApplicatPlanning and Development Services 2019 En Building and Code Regulation Division , Permitting 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT TYPE: R R-0 R0 S E Ell IMPROVEMENT LOCATION: Cn��rA JkJe dwe- Prop rty Tail Q'D� g' 000 /D Lot No. Site Plan Name: Block No. Project Name: DETAILED DESCRIPTION OF WOR/K: r .)I 1•:t C f'—� "'✓' 8 Yi•OfVL �p�rll. f b�Yi dWC0oi' 1 L'yY Slow zY',c gpe caft°v&*M 5 ` + Z$aD P I %�eTe Q rS Q�•BApL C, 6'f O: C.._ Gga (4 u.v 41; �.. II►�11�. lZ" riles( fz M' ' +'2 'f,.l+' w :•. a 'y�f CA OD • t! CONSTRUCTION INFORMATION: Additional work to be performed under this permit — check all that apply: _Mechanical _ Gas Tank _ Gas Piping _Shutters -Windows/Doors Electric Plumbing Sprinklers Generator -. _ Roof Pitch _ _ _ _ `ota V Con t ctitsn" 7_JB'���WMr Lp#Sq. Ft. of First Floor: , �TCp$' oL000s—t�ion;, 7/ i'%i�u!lljlll�000 Utilities: _Sewer _Septic Building Height: I • WNER/LE•SSE CONTRALTO Name tJgS Name: (+ @ ! Address: (V*cy%rA City: %f , �idl2C� State:r� /Ads7 Zip Code:?�'{d%S� Fax::: tate: 2 Phone No. ?&,yy L �Tv 3 Zip Cod Fax: E-Mail:6:(1t0#4O� Ak1r Pho No R.o Z 3 Fill. in fee simple Title Holder on next page ( if different E-Mail A4W"Le"C Afe from the Owner listed above) State o County L ense 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. MR DESIGNER/ENGINEER: — Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: _Not Applicable Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: OWNER/ CONTRACTOR AFFIDAVIT: 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 restrict or such may prohibit , structure. Please consult with your Home Owners Association and review your deed for any reslNctions which may apply. In conside'fation 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 T B SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT � ' 1YITH lyOU E R'a""TT61111111111&'BEFORE'RECORDING=YOIiR'NOTICE'OF tOMMENCEMItNT:"; _�,. �- i �3 `fit ,F_': ;ei c 1 -• ',a _ .»._r ..__ •1. Ae Signature of n Tessee/ ntfactor WAgent for Owners , Signature of Contractor/License Holder ;,-t, , ., ., ` STATE OF FLORIDA STATE OF FLORIDA \ COUNTYOF {JJCI COUNTY OF The fgrgoing ins rument was ac mowledg�before me f day of 20 by The forgoing instrument was acknowledged before me this day of 20_ by 1thiis V��1( ', W �i�,14 Name of person making statement. .Name of person making statement. Personally:Known OR Produced Identification Y PersonanyKnown OR Produced Identification Type of Ide•'ti ' do Type of Identification Produced Produced ;' c IIA Jam.' ...'t•....• , (Signature of No r' a (Signature of Notary;Public`st8te of Florida:) KAREN S:•NFELSEN issidi Commi No'�.SPate'of Florid B ry public Commission No. ;"(Seal) • y ,? Commission k. 0 G-207484•• „,°c' My Commission Expires REVIEWS ?;FRONT -' ZON N ,� ISO PLANS -'VEGETATIOW� SEA.TURTL MANGROVE .COUNT -ER,, REVIEW- ,t•REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 2/7/19