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Building Permit Application
Date: Permit Number:� I O.� Building Permit. App iIcatf©n . pign4ing pno gov' Jopme l �rvi� . gclil#in# and god# o ri:ion Pivi§iorr . 9399 VigiNg Avent4q,-ford Pkerco Fk 9499 Phone: (772) 462=1553: Fax: (772) 462-1578. Commercial Residential: X PERMIT.APP�JCATION-.FOR: ! . PROPOSE4 [MtP_ OUEMENT LOCATION: -Address: II.Y€RA:6W? . '. Legal Description:. 9-AF V9 OF §L�-@TIBIJ I = TOWN§HIP @4§ = RAN@9 @9 Property Tax ID #i Lot. No. Site Plan Name:0�4�TR`.��8 �YILLA€ Block No. : Project Name: Setbacks Front W. Back: W. Right Side:- AT Left Side:: 15' FETP►ILED 4k'All* ION ;OF WORK: WRA9 WILL 09 BUILD OFF REAR OF HOME CONSTRUCTION:UNFORMATION: . _. Additiona I work. to be _nertormed under this permit.- check E as Tank ❑ GasPiping a _apply.. s.. Q.Windows/Doors.®HVAC LJ Shutter Electric D Plumbing LISprinklers E ® Generator Roof Total sq. Ft of Construction: ,1 6 S . Ft. of First Floor:. Cost of -Construct ion::$ MAP Utilities: Sewer. .Septic Building Height: OWNER/LESSEE. . Cd;NTRACTOR:, r:a . Name YVYNHF- PLI PINQ R€PARTMOT . Name:--MATTNEW LYNXYYYNK . Address: POW §,QVTH UP. HWY,. tr 6WIT€ 402 Company: 4�'NN9 PLEYROPWNT 6Q09f ATION City: PPRT 6T. W011FE . State: FL Address: 6000 690TH 09 HIM, 1 4 3VIT9 492'. Zip Code: .04.02 :. - Fax:-(772_) 676.76� .. City: PQRT,6T.. WPM ... State: FV - Phone No: 0772).676-55i3: Zip Code;."W62 Fax: (772) 676-7656 Phone No.':(772) 676=554:5 E-Mail: _ 41.111 ln. 44 omplo title HAldar on.1)0xt page (it different E-Mail: from the Owner 11gw ?hANe) State or County License: - It daiMe of comtry0ion 10 $2500 of mare, a 99CORM Nottirg of Commgmawnt 16 regglred, SUPPLEMENTAL CONSTRUCTION- N:LAW INFORMATION F. DESIGNER/ENGINEER: _ Not -Applicable MORTGAGE -COMPANY _ Not Applicable . Name: 13RADEN&1 Rwm Name:. Address: 417CocONuravE. Address: City: STUART State: FL City: State: Zip: 34996 Phone: (72)287-825e Zip: Phone: FEE.SIMPLE.TITLE HOLDER: _ Not Applicable - BONDING COMPANY:. _Not -Apo licable Name: Name: Address:. Address: City: City: Zip: -Phone: Zip: Phone: 1 certify that no work or installation has commenced prior to the issuance of'a permit. St. Lucie'Countyy 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 Horne 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 improvements to your property. A Notice of Commencement'must be recorded and posted on the jobsite before the first inspection. If you intend to obtain financing; consult with lender or :an an Bef6re. commencin work or recordin : our Notice of Commencement... s _ Signature of Owner/ Lessee/Agent Signature. of: Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF S :: ���= COUNTY OF - _ c . The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this S day of d c;7m B 20 2uby this J $day of 0 GAB iX 20d-� by (Name of person acknowledging) .(Name of person acknowledging) (Signature of Nota ublic- State of Florida) (Signature of Noteo Public- State of Florida ) Personally Known- OR Produced Identification Personally Known OR Produced Identification Type of Identification. Produced Type of Identification Produced Commission No.. :':+ P:"',, DOR I+BASKIN Commission N ` • .RYA OTHYANN(IV - ' * MY COM ISSION # HH %5443. j .. ', MY COMMISSION # HH 04544.3 EXPIRES: October 2, 2024 I `� j _ i ::°fir d ;�•• Bonded Thru _ >`P`` �; • `• Itonde�i ThN Notary Public Undenxdteis ReVised /15/2®t w". REVIEWS FRONT: ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER, REVIEW REVIEW' . REVIEW - REVIEW. REVIEW- ..REVIEW.. DATE. COMPLETE ONITIAL. .06.