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All APPLICABLE INFO:MUST BE.COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number: ajoj - C)rDq ff
Building Permit Application
;Planning and Development Services
Building andCodeRegulationDivision COfY1171erGIBI ReSte ;2rltlaL X
22 00 Virginiq Avenue,.Fort Pierce FL 34982
Phone:(772}:462-1553'Fax.(772)462-1578
Ott,,K IITI APPLICATION FOR..� "3 4 ■ ��,.1�r �s°,i x e 6 � �s s3 ,.r,� �"'t y � -°.`�{� z s� .
Address: .95 S Brocksmith Road
Property Tax lD f: 23018-311-0003-000-7 Lot No:
Site Plan Name: Block N;o
ProjectName:
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Relocate E(ectnc°:Service from,dilapidated bldg to a concrefe pole. „
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,New Electrical Meter: . Second Electrical Meter
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Additional work to be:perfoerried' under-this.permit-check;all that apply'-
-Mechanical _Gas i a,nk- _Gas Piping _Shutters _Windows/Doors _,Pond
Electric _;Plumbing ,Sprinklers _Generator —Roof Pitch
Total'Sq. Ft of Construction: ! Sq.Ft. of First Floor;,.
Cost of Gonstructian."$ 1500:00
Utilities:
_Sewer - Septic" Building'Height: -.
��'. x S „� ` w� a `�3 i 3t � � � ,.n 53" � r� ,z z �• 3� ,� -nezt � ..
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Name NK Landholdings iName:'Joseph E Hemdon,,Sr
Address: 302.S. Br'ocksm'th Road Company,: JoeNs Electric of St Lucie Cnty.,„lnc;
"Fort Pierce. 1206 B ell Avenue'
tY State:_ Address:
Zip Code: 34945 :Fax:,,772 467-8923, C[ty Fort Pierce State:FL
Phone No. 772 467-123i) 34982
Zip:Code Faxs .
-keeer;com
465EMail. Sewarf@Ntures Phone No '2.363 -
Fill',in,fee simple Title"Holder an:next page"(lf-different E-Mail loes@usa.com
frorn the owner listed, above) State or County License EG13007203
n
Ifwalue.afconstruction"is:?S00 or more,a RECORDED'Notice�of Commencement is required.
If value of HWc,!s$7,500 or.morei a.RECORDED Nonce of Commencement is required.
......._......_....
" DESIGNER/ENGINEER X_NotApplicable. MORTGAGE.COII�PANYc- x_, tVot:"App{icable
Address: Address:
city: State: CItY State:
p, Phone Zip:: Phone:
FEE SIMPLE TiTLE HOLDER: x_Not Applicable BONDING
COMPANY-X. Not Applicable,
Narne: Name:
Address:
Address:-
city:
City,
Zt'p Phone Zip:. Phone-
OWNER/CONTRACTOR AFFiDViT::Appl cation isherebymadeto..obtain apermit-todo•theworkand installation as indicated:
f certify that no-work or installation has.commenced prior.to the issuance of a permit,
St. Lucie County makes na-representation-that is granting a permit will;authorize.the permit holder to build the subject structure;
which"is in eon list with any applicable Home Owners Association ruies,bylaws or;and.covenantsthat mayrestrictorprohibit 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 exemp#from undergoing a fullcon.currency review:rosin"additions,
accessorystructures,swimming:pooh fences,walls,sigos sereeh.rooms..and accessory uses to;another non-residential use
WARNING TO OWNER:Yourfailure 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 Courity and posted on tfie�obsite before the first inspection If you intend to,obtain'financing, consult
with lender or an attorney before commencingwork.or recordin our Notice of Commencement:
r ,
atur, f Owner/Lessee/Contracfor'as Agent for Owner Sign " re of: ont a ctor/Llcense•Holdei
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF sTLUCIE_ COUNTY'OF 'STLUCI`E.
Sworn to(or affirmed).and subscribed,before nneof Sworn to(or affirmed)"and subscri bed-beforeme:of
R," .Physical Presence or Online Notarization X : ,,PhysitalPresence.or Onlirie.Notarization.
this e_: day of DULY ,2020, by this s, day=of Ju v 202q by
Jose0 E:,Hemdon sr. Joseph E.Hermdon;Sr. "
Name of person..ma"king statement. Narne.of person making statement.
Personally Known"x OR Produced Identification,. Personally Known x. OR Produced.Identification
Type of,ldentification Type of identification
Produced' Produced
(Signature"o `otary Public-State of Florida) (Signature ` Notary Public=State of Florida
Commission No. 3 T3R ommission No. �
Randolph:MCL7anie! � � 14 any Pubfm-S�be ssr Ftaid�
MY Commission GG`35a355, r" .Randolph;MC[}artie!
y ommiss+
Expire OBi0i 023
REVIEWS. FRONT PLANS''" VEGETATION, `5�
COUNTER REVIEW` REVIEW RE1>lEN/ : `_REVIEW �R .1
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DATE;
RECEIVED,
DATE:.,
COMPLETED
ev."