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Building Permit Application
ALL APPLICAB E IN O MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number. v_ 1 - ;ti:zra Y-- m 9 r - APR ; 1 2017 Building Permit Application Planning and Development Services LUci��:auvei 1, a ~y �,'l , FL Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: Pool inground Address: 1 Legal Description: �S .3* •• 1' P (14�� W l bo 2-F Property Tax ID#: 3a3i- tool• ©DD-(� Lot No. Site Plan Name: Block Block No. Project Name: UU Setbacks Front Back: a Right Side��q Left Side: .r.' 1'ti 5`-lOL-[ u)L fop( Lij i44, C'e9nU:2 . + tt?a.:.lr� �_:-::.* :ram. .�aj�jn�...N rs -ylr,^{ y,},r,r -yS+c�{iJi:y.xtw�e �...}��.r„r�,t{rfSy, a tE' -•� H�.;%,' -.t uc1+7 '.u� i{f za. ��,y�tr+ p X.s73�'" w,t:. t �Y�. jks.�t �� ff 2 ibjs.� --5 t��s�� :�.•�' �s�t A t - r y "'�4 tf Et � , ,CONSTRUC;TIO;N INfORM4�TION � ��gt t 4. x �r, .. f xi.. `Y ar -`t t r5 t tl-� y. ,r. -.., r� ., n r".s.,� ,s}„ .,k"5. .ram -,�.. _4.a+,r. ,'i"cT.lc�.ser-fl Additionalworkto e e orme under this permit—check a apply: ..:, . ❑HVAC 0 Gas Tank Gas Piping _Shutters ❑Windows/Doors FlElectric 0 PlumbingSprinklers El Generator 0 Roof Total Sq. Ft of Constructio : S . Ft.of First Floor: Cost of Construction:$ f� Utilities:i Sewer 0Septic Building Height: Name t Name:0&(r1e QQ Add -6v Company: rI f 6&v—m4c- Rooln, �i��-r City: UY}" � � State:_ Addre�s-s-:L�10 (:[�l/� � Zip Code: $ Fax: City: R. �ler�2 _ Stater Phone%0��n Zip Code:* vl- Fax:77P•'�4v7-11obt-4- E-Maille-�l�� le �-,Q�1 ,i��Phone No. 77 8 . ,T75a r Fill in fee simple Titolder on next (i£d! erd.., E.-Mail: F112rn0-0 . a nn from the Owner listed above) State or County License: C O If value of construction is$2500 or more,a RECORDED Notice of Commencement is required. I .I 'SU,PaPLEMENTAL=�'CONSTRUCTIONiiLIEN'�iLAVU�INFORMATIONL;F;�„� 1S :4 r ;� ,3 f�.�.,`�}�,�" ,=u DESIGNE /ENG�VEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable Address:10 0 ; aer Address: City: State: L. 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 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 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 attorney before commencing work or recording our Notice of Commencement. s Signature of Owner/Lessee/Agent Si ur o � o der STATE OF FLORIDA OF FLORIDA IU COUNTY OF �� ATE' �I COUNTY OF 8�• � c The forgoing instr ent wad cknowledged efore me The forgoing instrument was acknowledged nbefore me this day of 20 �by this, day of 20 !__L by �a rn QS 1 40 rw-ed (Na of perso cknowl dging) ,(Name person a wl i ) a . _ (Signature of Notary Public-State of Florida) (Si nature of Notary Pu lic-State of Florida) Personal) Known OR Pr duced Identi icatio Personally Known OR Produced Identifi ation Y Type of Identification Produced Type of Identification Produced o�*""'" ;': FARA® HE�PNAN®EZ 'P'°��4: FARA D HERIN4AMIDEZ Commission o;' MISSIN �F172419 Commission a MY COMMISSION#FF172419 `�: Or PIKES October 28.2018 -0153 FloridallotaryServict•com Revised 07 (407)399-0153 Floridallotarys&vice.com ' REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE �I i INITIALS