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BUILDING PERMIT APPLICATION
All APP, (CABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _f]ate_1 � 1 �d � �� Permit Number:BY 51 Ude County IVED f . Building Permit Applicati0 2018 Fn p - y'. evml@Elfi 32 52-1578 Commercial Residential Addres'I� sI I: Legal Description:` `I Prope Tax ID#: IyaO— ��],yCjOq—did—� Lot No. Site Plzi Name: Block No. Project Name: Setbac _ s Front 10 o Back: Right Side: S J eft Side: �� I DETAbLEO DES• C�R�IPTI.ON Of W©R JI CONSTRUCTi s INf©R Additid nal work to be performed uncler this permit —check all t at app y: chanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors ZEllectric +/Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sil Cost of Ft of Construction: Sq. Ft. of First Floor: II �� IConstruction: $� 00 Utilities: _Sewer _Septic Building Height: ;Name Addrels: lCity: Zip Code:) Phon . E-Mai Fill in, " Com an Address: City: �\ State: Zip Code:cq� y 91-Fax: Phone No •Q�ia E-Mail i�e55 er(P �%c" C4 State: 19 "G Fax: �� 3 9 9 11No. ��'' 3 1� I. simple Title Holder on n t page ( if different from lee he Owner listed above) State or County License 0 If value f construction is 2500 or more, a RECORDED Notice of Commencement is required. Ifl S PPLEME TAL @ONSTRUC�+T(t?N LIEN W I'NFQRMATtO DESIGNER/ENGINEER: _ Not Applicable Name: Address: City: State: Zip: Phone MORTGAGE COMPANY: _ Not Applicable Name: Address: City: State: Zip: Phone: I FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: Address: City: Zip: Phone: BONDING COMPANY: Not Applicable Name: Address: City: 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 jobs'.te before the first inspection. If you intend to obtain financing, consult with lender or an attorney before commencing work or recording our Notice of Commencement. Signature o r essee/Contractor as Agent for Owner Signature of tractor/ ' nse H er STATE OF FLORIDA COUNTY OF P1 STATE OF FLORIDA COUNTY OF�n The forgoing instrument ent was acknowledged before me this 0 day of 20� by The for oing instrument was acknowledged before me this day of - 20�ff by L (_ Name of r on making statem Personally Known v OR Produced Identification Name of person aking statement. P n C---' OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Notary Public- at .p ,lor'��J�a� public State of Florida c Y Helen Katherine HBnrahan pIission GG 211szoCommission No. �or �oExpires 0811812022 ignature of Notary Public- St to q-f:F,lorid ).` ov b� ,:;, .\fyuC!•c b!; cN of Florida ? ; --•.Helen na.t:h.ei in,, Hai-mha mmission N xiraicGG 211520 or aot�lK, pes)A!18!2"22 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 812/3.7