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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO RE ACCEPTED Date: 7" Z 0 - '.-� Permit Number: TM, L,W:C2L ;.vc.�. i =ter is - ; - Building Permit Application planning and DevelopmentSemices Building and Code Regulation Division Commercial Residential 23oo Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462.-1578 PERMIT APPLICATION FOR: 0O L-Al_ PROPOSED IMPROVEMENT LOCATION; 2: �j D C` 16 [9!-�L�CaG" � Address: � � S � �'�" Lot No .� Property Tax I©#: Block No. Site Plan Name: Project Name: DETAILED DESCRIPTION OR WORK: 2� L.v Al New Electrical Meter Second Electrical Meter (Affidavit required) CONSTRUCTION INFORMATION; Additional work to he performed under this permit —check all that apply: Pond Mechanical Gas3ank—Gas Piping ---5hvttw * Generator Roof --Pitch Electric _„_Plumbing —Sprinlciers r.... -- Total Sq. Ft of Construction: Sq. Ft. of First Floor. Cast of Construction: �& _. Utilities: Sewer Septic Building Height:_ _ OWNER/LESSEE: CONTRACTOR; 7 i it !l`iJ 1 N Address• �J company:If Ilk 61 J State:_ Address: Z . City: 4~ Stater Zip Code: a Fax: City Zip code;.-- Fax~� C7 Phone No. -l- Phone No EMai in tee simple Title Holder on next page { if different E Mail 0 Fill 'from the Owner listed above) State or County License if value of Varna of HAVC is $9,Soo or Moruction is 25013 orena RECORDEDaRNcmce ofCcommencemee of nt� is egUi eduirad. I€ SUPPLEMEKTAL CQ�ISTRUCT{Ol1l LIEN IAVIf INFORMATION: MORTGAGE COMPANY: Not Name: Address: State:,_. City: pe Zip: hon FEE SIMPLE TITLE HOLDER:. Not Applicable Name: Address: City: Zip: Phone Not Applicable Name' Address- State: City: Zip: Phone: BONDING COMPANY: Applicable Name - Address: City: Zip: _...�� Phone' R CONTRACf'DR AFFi®ViTt Application is hereby made to obtain a pertmrtto do the work and installation as indicated. OWNS f t certify that no work orinstal. - Ian has commenced prior to the issuance p p St. Lucie Counttyy makes no representation that is granting aermixwiii bylaws nr and cnvenholder n fihat may rest subject r ho structure t such which is in confiictwith any, applicable Home Owners Assoc ation ruses, our deed for MY restrictions which may apply structure. Please consult with your Home owners Association and review y perform the work in consideration of the granting approved f plis anree that I s, Florida 8u ding Codes and St. Wcte CountuiAmendments. ts In accordance with the p review: room additions, The following building permit applications are exempt from undergoing a fuil cancurrency OrVuses to another non-residential use accessary Structures, Swimming pools, fences, �COrfiigns, screen rooms and accessa Notice of Commencement MaV result in paying twiceb� c records of St. WARNING TO OWNER: Your Witure to A Notice of Commencement must be recorded in the p improvements to your property_ County and posted on the �obsite before the first inspection. iourr Notice of Cto ommecfinancing,. consu t i_UCIe Ciu Y I' _ _ ,_ _t__ ..._, rn anrtna Work or re Lessee/Contractor as Agent for STATE ®F FLORIDA <& COUNTY O� Swarr�p Ear a#Firmed an subscribed before ye o7t� hysicai Presence or _online Notarization this'idayof Ii"" aka a of person ma�C g statement. Personally Known. ��OR Produced Identification .� Type of Identification Produced c A. c A _ A - 3gnature of Notary Public -state of Florida) }filTriissio a Y a Notary Public State C)Toaj ;4 5uzet e 1 G�t1E v �y Co[rm'sssion GG 135736 Expires 1y1212t}21 ar tti VEGETATIONPLANS REVIEWS FRONT ZONING S RE111E1NPERVISOIt REVIEW REVIEW COUNTER REVI SEATURTLF I MREVIEW ANGROVE REVIEW