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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: •��
Building Permit Application 1
Planning and Development Services p ®�
Building and Code Regulation Division Commercial Residential X ear ?p
2300 Virginia Avenue,Fort Pierce FL 34982 Lucie I
C rry
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Phone:(772)462-1553 Fax:(772)462-1578 �hty t
PERMIT APPLICATION FOR: Demolition
PROPOSEp 11VIPROUEMENT ,PCATION
Address: 4000 Edwards Road, Fort Pierce, FL 34982
Property Tax ID#: 2429-222-0005-000-0 Lot No.
Site Plan Name: Block No.
Project Name:
F_1PETAhLED DESCR IPTION IOF'�WORK
„. .
Demolish wood frame°structure. (No concrete slab/wood floor)
New Electrical Meter Second Electrical Meter
CC►NSTRUCTION INFQRMATION:
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 _Roof Pitch
Total Sq.Ft of Construction: 988 Sq.Ft. of First Floor: 988
Cost of Construction:$ to-(SC) Utilities: _Sewer _Septic Building Height:
01NNER/LESSEE CONTRACTOR
Name William Hardman Name:Self
Address:4013 Greenwood Drive Company:
City: Fort Pierce State:_ Address:
Zip Code: 34982 Fax: City: State:
Phone No.772-519-1100 Zip Code: Fax:
E-Mail:billhardman(a'_)pm.me Phone No
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) State or County License
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
If value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required.
SUP LEIVIENTAL CONSTRUCTIrON-,liEN� V INFORMATION
DESIGNER/ENGINEER: —Not Applicable MORTGAGE COMPANY: _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:
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 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 attorney befor mencing work or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF F A 1 _ STATE OF FLORIDA
COUNTY OF . ^�•�C,c-s'=' COUNTY OF
kwprn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
ll�- Physical Pres n or Online Notarization Physical Presence or Online Notarization
this , 'day of Zgby this day of ,2020 by
`\ a(5;�I
Name of person making statement. \ / Name of person making statement.
Personally Known OR Produced Identification Personally Known OR Produced Identification
Ty de tificat' Type of Identification
roduce e� N►C�2N�9 ' Produced
��•%A,. .
u of Nota r' (Signature of Notary Public-State of Florida )
:ot►RY°�"''- LISA M.E5P0 �:For,,]d
Commission No. _;�``� `- ry Publtc(�fb Commission No. (Seal)
Commission a GG 9
My Comm.Expires Feb
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.