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ALL APPLICABLE INFO ST B COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: (� Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Generator El
PROPOSED IMPROVEMENT LOCATION:
Address: ,U/�C � — n• Y`� � s�`-7
Legal Description: �q.ln 0-W ,7�57 �cJ Wlk_ li b�
Property Tax ID#: U04 'Bu —_'::S Lot No. C
Site Plan Name: Block No. SS
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
Additional work to� e e orme under this permit—check a apply:HVAC 13GasTank Gas Piping —Shutters Windows/Doors
Q
Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: r' S Ft.of First Floor:
Cost of Construction:$ G S•00 Utilities:uSewer Septic Building Height.
OWNER/LESSEE: CONTRACTOR:
Name Name: t4 W ale
Address: 55 W rw 0r n( Company: � l L-
r I
City: JP5 �i ry State: 9 Address: (0 S ►Vw Or
Zip Code: Fax: City: Cl`e State:
Phone No. �� �� �'� Zip Code: NAQ , t Fax:
E-Mail: Phone NAn'bead
Fill in fee simple Title Holder on next page(if different E-Mail: ( ra; CS• Lonn
from the Owner listed above) State or County License: r, C 1-30 b LDS
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
I
SUPPLEMENTAL CONSTRUCTION LIEN LAW 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:
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 wof k or recording our Notice of Commencement.
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Sign ure ctf cOne essee/Contractor as Agent for Owner Signature Co trac r/License Holder
STATE OF FLORID � , � �� STATE OF FLORP*
COUNTY OF c3 - �l t i2jr-e COUNTY OF Z=iV, UU C('Q.
The forgoing instr (ent was acknowledged before me The forgoing instrument as acknowledged before me
this day of i 20 by this-5 day of o n 20 by
' ,I Loy ay) V I hj- '0'� Aamym
(Na a of person acknowledging) (Name of son acknowledging)
(Signature of Notary Public-gate of Florida) (Signatu of Notary Pu ic-State of FI da)
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identificati Produced Type of Identification Produced
Commission No. Ll^&^^'� $e ate of Florida Commission No. ��, Notar�Public State of Florida
,sax nu, Notary l ubl+c � �° �,`��
�tj Antonia M Paula 4 ' ,• Antonia m Paula
cF'1912D1 k M ^ cc
" ; E' OFExpires 02/27/2019
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Revised 07/15/201�4
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE y-12-17
COMPLETE
INITIALS