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All APPLICABLE INFO MUST BE COMPLE D FOR APPLICATION TO BE ACCEPTED
Date: % Permit Number:
a
Z17
Building Permit Applicati n NOV 2 7 2019
Planning and Development Services
Building and Code Regulation Division Permitting LL�rtilerl
2300 Virginia Avenue, Fort Pierce FL 34982 St. Ll !Coe U t7 t�r/r FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Resi ia(-- - --
PERMITTYPE: eE nto (>
d ECVIENTIQGA`IIQN 0
Address:+� G I� /�147o 2 -.il 5�12 �FGf-� •
PropertyTax ID #: /^ go O /b 0 ^ Lot No. (o
Site Plan Name: /J)! rLO /` i N .s.�lQ- (1h tr• r�fy D Block No. fT�"
Project Name:
Additional work to be performed under this permit -check all that apply:
�
►�16na�echanical _ Gas Tank —Gas Piping _ Shutters
_✓Electric Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:
Cost of Construction: $ 3A cz�n
Address:/Y,S �/'�/'LT !ti&(CIR- 17A�
CityA)a5 i 19"—m - 6e14-_1F State:
Zip Code -AP 5-- Fax:
Phone No.��� ��y 9r
E-Mail-A-1.1 &Jr ® fi /41400 1 0fn
Sq. Ft. of First Floor:
— Windows/Doors
Vo"Roof Pitch
Utilities: —Sewer —Septic Building Height:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
Name:T--An,oww A A GG ZD
Company0 &-/A i A n
Address 6,40
City: lT s- State: rl_
Zip Code:_ ..Fq Fax:
Phone NoSZ1-32 (- 1'00a
E-Mail02�a ��.e0R.AWAn.@P-9MAIi, 1 Gc,*
State or County License 6C 0l q C/,26__
If value of construction is $2500 or more, a RECORDED Notice of Commencement is requirea.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: _
Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Namez` 'A'Q1,1_r—(213WAP65
Name:
Address:
Address:
City:
State: /�L.
City:
State:
Zip: —Phone
4 ? —
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _
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 YOUR PAYING
TWICE FOR IMPROYEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATEORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Owner/
as Agent for Owner I Signature of contractor/License Holder
STATE OF FLORIDA I STATE OF FLORI A
COUNTY OFCOUNTY OF
The fo oing instrument as acknowledge before me
this day of 20 R by
Name of person making statement.
Personally Known OR Produced
Type of Identificatio
Produced
( nature of Notary Public- State
�1of Florida )
Commission No. 63 V 160 'j0vu (Seal)
REVIEWS
FRONT ZONING
COUNTER REVIEW
DATE &6IQ
RECEIVED
DATE
COMPLETED
The forgoing instrument as acknowledged, before me
this � day of 20 %C[ by
ob14
z LL N ame of person making statement. 'r
aO
COO
ersonaliy Known OR Produced Identific Qn "
o x '
Wpe of ldentficatio
W.0
zaENEroduced as„3
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W O 3 3 C m
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si
of Notary ublic- State of Florida) a
n No. d0 (Seal)
C missiow
SUPERVISOR 1 PLANS
REVIEW -,r' REVIEW
VEGETATION I SEATURTLE I MANGROVE
REVIEW REVIEW REVIEW