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Building Permit Application
All APPLICABLE INFO MUST BE. COMPLETED FOR APPLICATION TO BE ACCEPTED Date: fo.^�S' O�co Permit Number: Building Permit Applicati Planning and Development Services Building and Code Regulation Division Commercial 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 I.PERMIT APPLICATION FOR: Do�,� -Cade, Cash. Address: 190 J U N 18 2020 ST. Lucie County, 2sidential u Property Tax ID #: -'OOy,/- 00 O. r7 Lot No. Site Plan Name: "nd_e�-/ l"Ro Block No. 6 Project Name: Dud' R,eAtial New electrical Meter Second Electrical Meter 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 _ Total Sq. Ft of Construction: 1000 -41A Sq. Ft. of First Floor: Cost of Construction: $ ,�000. 00 Utilities: _Sewer _Septic Name Address: Igo Oueew Ee,aen/ e r City: Fr. p�ejca e State: El - Zip Code: 3e!9 el Fax: Phone No. '%gig �v/6i 6".5`5119 E-Mail: • C7` //anr�eaQOoe� /4#0L©.reai Fill in fee simple Title Holder on next page ( if different from the Owner listed above) Roof � • - • Pitch' Building Height: Name: Company: Address -.- City: •-• State: Zip Code; Fax: Phone No E-Mail State or County License If value or construction is 7500 or more, a KECUKUEU Notice oT Lommencemem : is requireu. If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. _ MINE H 15 !IIi1M DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: Address: I City: State: City: 1 .State: Zip: Phone -Zip: Phl ne: FEE SIMPLE TITLE HOLDER: __;4 Not Applicable BONDING COMPANY: Y: 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. I St. Lucie County makes no representation.that is. granting a ermit will authorize the per it holder to,build the subject structure which is in conflict with any aplicable Home Owners.Assoclation'r.ules; bylaws or covdriants that may restrict or prohibit such structure. Please consult with•your Home Owners Association and review your deed'for ay restrictions-whlclf may apply. In consideration of the granting of this requested permit, I do hereby agree;tliat I`WIL iri all1respects,'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 mayresult} 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 orne before commence wor "or recording. ou,r'Notice:of,CQmmencement. r Signature of Owner/ essee/C tractor as Agent for Owner Signature of Contractor/License Holder . STATE OF FLORIDA STATE OF FLORIDA COUNTY OF S-\Y . -\)cAc COUNTY OF I ` Sworn 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 _X!!�_L day of 5il,ne . 20 by this day of I 20_ by 6, Sy t'.v, Name of person making statement. Name' of person making statement. Personally Known OR Produced Identification Personally Known:i''` ' OR Produced Identification Type of Identification Type of Identification Produced L `D L Produced eGIVENs (Signature of NoILI Signature of Not'a y;e blic-..±State,of;Florida),,; MY COMMISSION # GG 022023.�TCommission No:'3EXpIRE3{§ ber16.2026 Commission No. i" (SealBonded Thru Notary PublloUmlenHiters REVIEWS FRONT ZONING SUPERVISOR. PLANS VEGETATIQN; SEATURTLE• , • MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW, REVIEW"' ; REVIEW DATE 1 1. ,.•,� ,. RECEIVED DATE COMPLETED ev. i