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Building Permit Application
All APPLICABLE INFO MUST B.E COMPLETED.FOR APPLICATION TO-BE ACCEPTED 1 Date: `� a �. Permit Nuinbec: lj.l -1 • V i�l � ■11111 ` J RECEIVED f SEP t 41020 Building Permit Application • Planning and Development Permitting Department Services 5t.Lucie county! 'Building and Code Regulation Division Commercial Resideritial 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 PERMIT APPLiCATi.ON FOR: Address: 90 d U(2- ' Property Tax 1D#: l Lot No. Site Plan Name: Block No. Project Name: . l 01011,11,11 -• M_ �• �' �� rr"a r,u k_c c LJ t*eo- , S -- A 0 con G h l,cGcSt 10o etr_C4I,1SC iL-( New electrical Meter Second Electrical:Meter NMI �x''zr�;.. :,,`S' a�� 1iu ` 1. rs. � K+a.�`•�. ����� •,S''+� r � r': �S 1'4( ii J n Y' _�^n.a:-0r•z t;lti;Cfre� ,>r"45?ev4i4nY'.', Ft i i . .. ~c*,� 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: a /<(a Sq. Ft. of First Floor: r Cost of Construction;,$ 12r Utilities: `Sewer `Septic Building H'eight: •;y,7,•.---rt.•ro•y +•o+.: '7 ^+y'. •,Y�tif.,".�-•�'.�.;Eff.u�L,.1'.; i�.���'E£I.�n:[± k./ri,!i('.2rI,:lt,4t ,C.L.�!"'.••.;�i-cPt�m.fi��`st',ji�!1' 5'j�,;Jv7z,JCt�.N'��$4�r:'� �^".9"'III 1ir�i�c'2�.T�'srvG:::S�r"j`7".7,•'���'';s:..' rtirk iS"}'.t��}4.s'1'{.l�•-J.i:'•:4-�iar7r4{.r..r,^.d•'.kn-a.^�mE:ii�tS'4iC''.f:4.xr'Waaiia•u;+Y%.+a:� �..J'�.�..,'ti'' 11 �T'''•c�l�.T'rn:'r^:"a•1�'��'5.'E-'.f{;""�'. L'�••`Ry�•4a. �'c'i�T(}a�:e� : Name �.�C�� ri Ed IrIA©re [:f r`C.h '.Name:` :..- Address: i �-OR V,C'k5evg •five Company:. City: (=7 J}�,�CrG e State:�`I Address: 4 Zip Cade: 3(//: t Fax: State: Phone No. '7 7 Z '3 2- 7 Zip Code: Fax: E-Mail: I -"[+c,Lrtr+e III C)C-,,da % e h'1 Phone No Fill in fee simple Title Holder on next page (if different E-Mail from-the Owner listed above) State or County License I. 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. .DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not:Applicable Name: Name: Address: Address: City: State: City: 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 AFFIWIT:Application is hereby made to obtain.a permit to do the work and installation as iridicated. I'certiN thaf�no wark,.or,installationhas commenced priorto the issuance of a permit,. St.Lucie County makes rio representation"thatris grariting a perrnit;will authorize the permit%hdlder-to-build'the subject structure . which is in conflict with any applicable Home Owners Association rules,bylaws or and,covenants,that tray 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,1,do hereby agree that I.will;_.in al!'respects,perform the work in.accordance with the approved,plans,the'Florida Building Codes and St.Lucie County Amehilments. ' 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 :'iri provements�to your property,A•Notice'of Com'me'ncement rr u`st,be:recoeded:-in'the public records of St. Ducie County and p'oste'd on the jobsite before the first it speetion.-lf:you'intend to.obtaim nancing;:consult with lender or an attorniN before corer n "work or recording your Notice of Commencement. Signature of Owner/Lessee/Contractor as Agent for Own Signature of Contractor/License Holder STATE.OF FLORIDA _ STATE OF FLORIDA C.OU'NTY:QF' 1s1��t COUNTY OF Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of Physical Presence.or Oniine Notarization Physical Presence or Online Notarization this&_day of�' i?� 204,)� by this d6y16f ;20by Name 6f person making statement. Name of.person making statement. Personally Known OR Produced Identification Personally Known 011,13roduced Identification Type of identifi #%on Type of identification Produced �'l. `• Produced 1 • 0 ILA ."- (Signature of Nota (Signature of Notary Public-State of Florida} KAREN S. NIELSEN. bs" �-.State of Flea-lNotary Public Commission Na. =z ;. mrnissi ��G 207484 Commission No. Seal , My commissi oExpires June 12, 0 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION ' SEA TURTLE MANGROVE COUNTER REVIEW REVIEW. REVIEW REVIEW.. .REVIEW REVIEW' DATE RECEIVED DATE COMPLETED ev.579720