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Building Permit Application
All APPLICABLE INFO MUST BE C'__,?LETED FOR APPLICATION TO BE ACCEP �,,r'R' /l Date: �/ ��� Permit Number: o L=01 uilding Permit Application Plorining dfid Deiie16piri6nf S&Vie65 I I r%r- r-v% ►&-v- . Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 T Resid APR 15 2021 RECEIVED 4PR-72011 Permitti N. Department County al PERMIT APPLICATION FOR:Mvil4aellie-eOeet14G(S�ij' PROPOSED IMPROVEMENT LOCATION: Address: �f12� 'S_`' LM-'n'l ,plr/C!' /�-���lL' �%^�P//-P y/_ 3 9�% 5-- Property Tax ID #: 3 �f — �— �j% ��� dw / 33�3cJ�S Lot No. Site Plan Name: Block No. O,E Project Name: D eC DETAILED DESCRIPTION OF WORK: em v dle C/C /-e t,,/ New Electrical Meter Second Electrical Meter CONSTRUCTION INFORMATION: 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: &S Sq. Ft. of First Floor: Cost of Construction: $ Jyoo 6/0 Utilities: —Sewer _ Septic Building Height: OWNER/LESSEE: CONTRACTOR: 00 Name �G/'1� Name: COS? u ct/ l Address: C� 2 25 S �C/ f �ti� L. l� Company: C C ' / _ City: Imo9'e'iC� %%� State:�%f Address:446D IV, �il%16_klg4 K )Qb Zip Code: Ll �! S 7 Fax: City: 0 DUr?A J 6 State:_)5L Phone No. Zip Code: 92-9'3 S Fax: r— E-Mail: Phone,No 'i ? Z S Z 9 Z4/6 Fill in fee simple Title Holder on next page (if different E-Mailer Ci P .-7-2 _ C--r� State or County License from the Owner listed above) If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. If value of HAVCJis gk500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: / Name: 4y v q ()Jot Applicable ( MORTGAGE COMPANY: _ Not Applicable Name: Address: aVGnSwou Address: City: 4T Zip: 34W Phone -19I State:-0— - 2a-r7 '16k City: State: 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 inspecti If you intend to obtain financing, consult _ with lender or an attorney before commencing work or record' g r Notice of Commencement. SISKature of Owner/Lessee/Contractor as Agent for Owner Signatur on r r/License Holder STATE OF FLORIDA ^„ Q (// Q I STATE OF FLO�ITA�I'�� %.w IY VI �- /,&t `' I \.VVlrl l VI _�j Swo�to (or affirmed) and subscribed before me of Pysical Presefce or Online Notarization this day of /"l 200 by Name of person making statement. Personally Known OR Produced Identification /V Type of Identification Produced Y/ �` �i L •• // 2","�t-d 1 2�c ✓ (Signature of Notary, uoil BELINDAMALZACHER Commission No. Notary Publi�ge of Florida Commissi Ip 023005 Expires Jul 23, 2024 REVIEWS FRONT ZONING COUNTER I REVIEW DATE RECEIVED DATE COMPL ET Sw rn to (or affirmed) and subscribed before me of Physical Presen a or Online Notarization this day of 2020r'by Name of person making statement. Personally Known OR Produced Identification Type of Identification Produced 1hodo , Ad. (Signature of Notary Public- Notary Public State of Florida Commission No. My alato P�ion GG 184727 'o,0.d► Expires 02/11/2022 SUPERVISREVIIEWOR I REV EW NS I VEGETATIEV EWON I SEATURTEV EWLE I MANGROVEREVIEW All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Permit Number:1Q 21r0 WC019_ - RECEIVED 'J l.1 � ,...., 1 2021 a o a o D. ----- Building Permit Application .Permitting Department Planning and Development Services St. Lucia county Building and Code Regulation Division Commercial Residential 2300 Virginia Avenue, For` Pierce FL 34982 Phone: (772) 4624553 Fax: (772) 462-1578 PERMIT APPLICATION FOR:aialg ale PROPOSED IMPROVEMENT LOCATION: Address: J 54 4,4 Gr'(_ r)-i L5f-C e' EY- 3M 7 1 S Property Tax ID#: LI, - 50Y'- Q). SS _0'00 ._I Lot No. �%/✓� Site Plan Name: Block No.� Project Name: ''eC 41t?lrair/tl DETAILED DESCRIPTION OF WORK: /)/,J 1)"04- n 1 we T`r New Electrical Meer. — - - d Electrical Meter CONSTRUCTION INFORMATION: 11 Additional work to be performed under this permit- check all that apply: _Mechanical —'Gas Tank —Gas Piping _ Shutters Windows/Doors _ Pond _ Electric _ Plumbing _sprinklers Total Sq. Ft of Construction: _ Generator — Roof Pitch Sq. Ft. of First Floor: Cost of Construction: $� Utilities: Sewer Septic Building Height: - - "M " AIM to f 'ri.' OW N ER/LESSEE: CONTRACTOR:I J Name !1' io.� 1.4e 4G/eV, Na � r. Address: '�� ?a . ' Grz! cl ^� 1��� df /k/ Company:�V�21 =n f `%� n . J. City ?-��a` W 1. State: Address: f PG/ �f s Zip Code: 3 f` `� Fax: City: 77C..--tre, Stater Phone No. y it J % " 5.3 Zip Code: 4r E-Mail: Phone N Fill in fee simple Title Holder on next page (if different E- C4 0044-1101 State or County License 1? _f92 from the Owner listed above) If value of construction is 2500 or more, a RECORDED Notice of Commencement is requires. 'if value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable MORTGAGE'COMPANY: Not Applicable ,. Narne•. CcI'�t -1✓t & i,. �:�js _ Name:. Addres • . N K" iV Ud Q,Ve11'5W0oW -1,nD Address: City: `vr 5 F. ".c=sZ -State: rFl- City: State: Zip: S HJJ..3 Phone '7t7 Zip: Phone: g FEE SIMPLE TITLEHOLDER: _ Not Applicable BONDING COMPANY: N i is le Name: Name: Address: Address: City: City: Zip: Phone: Zip: Phone: a 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 thatl 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,'walIs, 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 wi+t, 1-4.r nr on a++nrnmf hafnea rnm manrina %Arnrle nr rorni-dina vnitr NofirA of Commencement. z�CA S gnature of owner/ essee/Contractor.as Agent for Owner Signa ure of Contractor/Liven Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF Zworn to (or affirmed) and subscribed before me!of Swo to (or affirmed) and subscribed before me of Physical Presence Online Notarization X Physical Presence or Online Notarization or this � day of 9_?1V -C� t by this day of 202b by Name of person making statement. Name of,persorUmaking statement. Personally Known OR Produced Identificatior>_ Personally Known OR Produced Identification - Type of Identification y�D Type of ldenti ion ,Produced Produced r L (Signature of Notary Publicl�l;� ublic State of Florida (Signature -5wip.of Florid .(j..�� Commission # HH 047054 M ")Expires 28,2024 Commission Not ©q .• y 9" P p Commissi o`;�Y°�'- KAffElo S. NIEL�E�� �`�.State f Bondedt rough National Notary Assn. - _� *= Commission# GGa2074840 My Commis une 12, 2022 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETA NGROVE J0WQffA4L &QgW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE `;: COMPLETED • Rev. 516126