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!� All APPLICABLE INFO MUST BE COMPLE rED FOR APPLICA T Iu"J TO BE ACCEPTED �
Date: �`�JI�a. Perm.Number:
RECEIVEDl.
L..LLUS I
9 I u M, MAR 3 0 2u22
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I E `, L ...� L Building Permit Appikation �t.1-00la,County
Planning and Development Services �',miitting
Building and Code Regulation Division CDr71mer'Clal _ _ Residentia! �S
i 2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 C!✓D'_ I nding
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PERMIT APPLICATION FOR:
RkfDPOSED-IMPROVEMENT 0 C. N
Address: 5l h� '_P)C113qM
q � [1 - -- --- --
1� Property Tax ID#: 3 ma �I'�D-G'Y 3(.-- @0ID a Lot No.
Site Plan Name: _ Block No.
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rrcj: ctName:
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D E tAdLED DESCRIPT(QN'"O'r <iFtl�
_-K2rn-oved And R_-e�j PiCtPkI naide ctna -o.�. ,Sidi. e, un i x �
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Nes,v Electrical Meier~—_ Second Electrical Meter_—_ (Affidavit required)
! C'C N, SI. UCTION INrC�R11fIA I sGN
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j3 Addirienai work to be performed under this permit- check all that apply:
i V Mechanical -Gas Tank -Gas Piping -Shutters —Windows/Doors -_Pond
Electric Plumbing -Sprinklers Generator Roof Pitch
--- -
Total Sq. Ft of Construction: Sq. Ft:of First Floor:
Cos;:of Construction: $. _- Utilities: _Sewer _ Septic Building Height:
- 71
�INNFR�l.ESSE°E CONTRACTOR. I,;
iI Name
Name:
Address:
` V1%)X ! Company: _ —_tc.� ne 0.r _ec',O. ,- A
City: c Pi2 rc�. --- --State:State: -1, Address: A
1" �
!,! Zip Code: 3�� �-Fax: - - --- — ! :iry: ct State:
F
Phone No. _ ----_-_ -E•- �'Zip Code:���B Z/ _ _Fax: �.
i Mail: I Phone No .��a� 9-7 97-14
Fill in fe(A simple Title Holder on next page (if different, I E-Maif_ e rne-C Cc_Aj e.c_� @ IoO CATm ;eE
s i frrrn the Owm-r listed above) j State or C Chin y License cmC-7. a(9
II r
II value of construction is 2500 or more,a RECORD
i 11 N;�i:ce of Corrlrvsencn_ rer�c s rer�uirecl. !!
t' If value of HAVC is$7,500 or more,a RECORDED Nnfice of Cc.-mmµncement is required. !1
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StJi�€�LEI�IENTAL CONSTRUCTION LIEN LAB IN1= Ri`r���TIC}�el, n ,_
DESIGNER ENGINEER: Not Applicable e y'
I� / — pp MORTGAGE COMPANY: I�Not Applicable
Name: Name:
Address: Address: ! 4;
City: State: City:, — State: c�
Zip: Phone Zip: Phone:—
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: 1Dc Not Applicable
Name: Name: i
Address: Address: I rt
ek
City: _ _ City:
Zip: Phone: Zip: Phone:
i
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. i I
I I )_•t. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which conflicts with any applicable Homeowners Association rules,bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Homeowners Association and review your deed for any restrictions which may apply.
in consideration of the granting of this requesUed permit, I do hereby agree that I will, in all respects, perform the work f
in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments. f¢
I The follo%ving 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 ¢�
I `u+'AR,,lie\G TO OWNER:Your failure to Record a Notice of Commencement may result in paying twice for '
imps ove:ments to your property. A Notice of Commencement must be recorded in the public records of St. yi
Lurie County and posted on the jobsite before the first inspection. If you intend tolobtain financing,consult .
Niith lend ran attorney befor ,mmencing work or recording your Notice of Commencement.
1 ! Signature of Contras or-4K Owner Builder as applica l JANAL.BRIDGES ;y
= Cammi89lon I HH 041043
r I STATE OF FLORID N ° f`: Exprres September 13,2024
11 ' Cl�t�NTY O F +tP' Banded Thu TMy Fain on b= ce 8*a8�T019 I I
Sworn to(or affirmed)and subscribed before me of Physical Presence or Online Notarization It
I'this day of ,20,^9by �Q,C�q•Y,�,�y� �� ;I
I it
Name of person making statement. ! f
Personally Known OR Produced Identification
Type of Identification Produced
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(Signature of Notary Public-State of Florida) a
i Commission No. —(Seal} p�
REVIEWS FRONT ZONING SUPERVISOR i PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW I
DATE - - ---- -------+ a
i ! e
RECEIVED
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