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`- All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: ® I I ^ LJ
RECEIVED
B61.1ding Permit-Application NOV 0 6 1020
Planning and Development Services Z.
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue,Fort Pierce FL 34982 5t.Lucie County
Phone:(772)462-1553 Fax: (772)462-1578 'Commercial. Residential X
PERMIT TYPE:
Address: (-�l"�� .J 5 ; - 0-T P(ol2CG
Property Tax ID#: o2 LtC) �C�-��-- "` Lot No.
Site Plan Name:-CL\JD�F LF iEr ff!M Block No. _
Project Name:
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
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ i'�77c 53 Utilities: _Sewer Septic Building Height:
Name �11\`� NameAMES':9.DAVIS
Address:'40-7 /V ::�9TH STY26C- - _+'_ Company J.&G,CARPENTRY, INC.
City: 1-1 `t State L Address 13 11. . 9TH CT. N.
77: WEST PALM BEACH FL'
Zip Code: Fax: City. State:
Phone No. =7-72..(.e2L& ,:326(o . Zip Code 33411? - Fax: 561-855-4054
E-Mail: Phone Nt�561r-855=4052
Fill in fee simple Title Holder on next page(if different E-Mail' �,r�,M o woet'-�
from the Owner listed above) State or County License CGCO228
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.
i
DESIGNER/ENGINEER: X Not Applicable MO 19tP-3J VIPANY: 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:
I
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 authoriie-the ppermit 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;:Fiio hereby:agree that will-in all respects,perform the work
in accordance with the approved plans,the Florida BuildtngDdes and St t�u�IeCtStir�tX Amendments.
The following building permit applications are.ezempt;rbm:undergoing a tgl4� 00�uflgnry review:room additions,
accessory structures,swimming pools,fences,:walls,s gns,.screen rooms anckac.cessory uses to another non-residential use
.•:
"WARNING TO OWNER: YOUR FAILURE TO RECO e A NOTICE'.�OF-'COMEIIIIENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR,PIigOPERTY. A- MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIBS ,IiNSPEGTIIOf�.5 E'F:* U,I ND.TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFOk.E RECORDING ,Wk k0t10E.OF'COMMENCEMENT."
Signature of / sse or as Agent for Owner SigrWre ofrContractor/License Holder
STATE OF FLORIQA STATE..OF,FLORIDA
COUNTY OF_ COUNTY OF PAumBEAcm
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this _day olb�17 20aQ b by this day of j,)n11 ,av, gx, 20_Qo by
\ e JAMES D.
Name of person making stathment. Name,bf;,person;making statement.
Personally Known OR Produced Identtffcatirr Persona;ly°1Cnom x OR Produced Identification
Type of Identificationldef5tfrfration
Produced \.:1D L ;-�``•5 Produced;
I
rl A.n, r m Iq
(Signature of Notary li igna re bflo ary Publ' -Sta ldrida _�
? :!+a DEANNAMARIEGNENS r' * r * (�ommiss�n:PGG 58E54
Commission No. ;a, MMISSIONAtGGo22D2 N ,, o� E iresHpril12,2u24
(��y� Jp�� mmission No.. / rn{
:o? CX�II'(tS:December 16 2020 9TFo F�o�� \13�163Ihru Budget Notary Seivices
Bonded Thni Notary NbUt Undenwff rs -
i Irr
REVIEWS FRONT ZONING SUPERVISOR PLANS. VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW,. :' REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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