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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 114011 -
Date: September 7, 2017 Permit Number:
RECEIVED SEP 19 2017
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 xx
PERMIT APPLICATION FOR: Shed site built
PROPOSED°IM°RROVEMfiENT.LOCATION� °
Address: 5220 NW Dunn Rd., Fort Pierce, FL 34983
Legal Description: DUNN ROAD ESTATES S/D (PB 46-1) LOT 5 (2.43 AC) (OR 3895-624)
Property Tax ID #: 3403-702-0006-000-3
Lot No. 5
Site Plan Name:
Block No.
Project Name:
Setbacks Front ( f Back: Right Side: i.� Left Side: IDS i
DETAILED DESCRIPTION OF WORK
r
Shed installation. l 2 X (It
C-ONSTR'UCTION,],.N—FQ'RMATI,ON ,
itionawor to e eorme un e,rt isper�m�
it—c
fas Tank ❑as
ec aMutters_a.py:❑HVAC ❑Windows Doors
Piping
❑Electric
El Plumbing ❑Sprinklers
❑Generator DRoof Roof pitch
Total Sq. Ft of Construction: Z%6
5 Ft. of First Floor:
Cost of Construction:
Utilities: Sewer ❑Septic Building
OWNER/LESSEE:::
Height:
Name A Pink Jelly Bean Inc
CONTRACTOR;
Address: 1082 SW Bayshore Blvd
Name: Julio Batista
City: Port St Lucie State: FL
Company: JC & Sons Home Builders Inc
Zip Code: 34983 Fax: 772-879-2070 —
Address: PO Box 7247
Phone No. 772-618-5244
City:.POrt St Lucie
E-Mail: a@c21silva.com
Zip Code: 34985 State: FL
Fax: 772-879-2070
Fill in fee simple Title Holder on next page (if different
Phone No. 772-618-5244
E-Mail: a@c21silva.com
from the Owner listed above)
If value
State or County License
a6
of construction is $2500 or more, a RECORDED Notice of Commencement
is required.a3
SUPPLEMENTAL CONSTRUCTION' LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: A Pink Jelly Bean Inc
Na me: Julio Batista
Address: 5220 NW Dunn Rd., Fort Pierce, FL 34983
Address: 1082 SW Bayshore Blvd
City: PortSt Lucie State:
City: Port St Lucie State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Applicable
Name:
_Not
Name:
Address: Po Box 7247
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 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 work or recqrding your Notice of Commencement.
Signature of Own r/ Lessee/Contractor as Agent for Owner
' Ignature of Contractor/License Holder
STATE OF FLORIDA -
COUNTY OF .S e- WC'(F
STATE OF FLORIDA
COUNTY OF ,.ST 4 I.t Ul
The,for oing instru ent as a'I: nowledged before me
this ay of 20�by
The forgoing instrument was ack owledged before me
this of� ,,r. 20J7by
AL-B&M 4,V#
--ju L
Name of person aking statement
Personally Known OR Produced Identification
Name of person making statement
Personally Known (/ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
izr
Si ature of Notary Public- Sta
51�t+ s
Commission No. V rD7
51,
:°�•... V JANET BOSS!
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- (5a&y COMMISSION #
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EXPIRES October 21,
1097) "1 3 11 9 1 "153 FloridallotaryServi
re of Notary Public- St epr
NOI. t
F ri ion No. I: (Seal);OMMISSION #F
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2017 EXPIRES October 21,
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REVIEWS
FRONT
ZONING SUPERVISOR
PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER
REVIEW REVI W
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
l
DATE
COMPLETED
Rev. 8/2/17
172
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