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DESIGNER ENGINEER: _,_„_Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone;. Zip: Phone:
FEE SIMPLE TITLEHOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address.
City: City:
Zip: Phone: ZIP: Phone,
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,wells,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
rove n,t,s to your property,A Notice of Commencement mu e recorded and posted on the jobsite
f
beforeZ first inspection. If you intend to obtain financing,cQn nder or an attorney before
com cin wo;kor recording your Notice of Commencerright5spw
i,A�VAV'e SA"
signAgent 4slgn 00 Contractor/LicenseWre(/Owner/Less*
STATE OF FLORIDA,, - SfkTE OF FLORIDA
COUNTY OF
,'--�A?I u, COUNTY OF uLuc,E
The Ing.instrumerlt was acknowledged before me The forgoing instrument was acknowledged before me
this�Mday 20 LSLby this 2ND day of OCMBER 20 11—by
WbQ r4 Lyd (o ROBERT LVDL.UM
(Name of person acknowledging) {Name of person acknowledging)
01CL :!
(Signature 61,Mctublic(ttate of Florida) (Signature of Notary gmblf*ate ofolorida
Personally Known -�P4 OR Produced Identification Personally Known x OR Produced identification
Type of Identification Prod Type of Identification Produced
fvly( mII )t Immi
Commission No. SSON EE8542ssion No. FEE W=__
IEXPIf S January 08.2011
RHONDA LAFFERTY
71 0 1 Ed FlaidaWarySWtCe-COM SION"ESSQ97-
12�_Wr EXPIRE8 January 08,2017
Revised 07/15/2014 (4M 3$"155
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 x`54 �S Permit Number:
RECEIVED OCT 0 51015
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax: (772)462-1578 Commercial X Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line v,Mb'1
}P:ROPOSED IMPROVEMENT LOCATION:
Address: 6556 SOUTH US HIGHWAY 1 #4
Legal Description: TREASURE COAST CENTER BUILDING-B UNIT 4
Property Tax ID#: 3415-503-0004-000-5 Lot No.
Site Plan Name: TCBA Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED I DESCRIPTION 'OF WORK:
ADD PLUMBING FOR LAUNDRY SINK
CONSTRUCTION 'INFORMATION:
Additional work toe e orme under tispermit—c ec a appy:
11HVAC Ei Gas Tank Gas Piping _Shutters Windows/Doors
Electric ✓❑ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 400.00 Utilities:In Sewer Septic, Building Height:
°OWN ERAESSEE:' CONTRACTOR:
Name -r0_,6A Name: ROBERT LUDLUM
Address: IPS7PQ S-IeCUAJ A c h(IW.L_ Company: AQUA DIMENSIONS PLUMBING
City: 34 Pu ca State-�_4 II Address: 1651 SW MACEDO BLVD
Zip Code:3gq,32t Fax: City: PORT ST LUCIE State:FL
Phone No. Zip Code: 34984 Fax: 772-343-7418
E-Mail: Phone No. 772-344-8433
Fill in fee simple Title Holder on next page(if different E-Mail: adps@aquadimensions.com
from the Owner listed above) State or County License: CFC057526
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State. City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLEHOLDER: Not Applicable BONDING COMPANY: —Not Applicable
Name: Name:
Address: Address.
City: City:
Zip-, Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie Coun makes no representation that is granting a permit will authorize the permit Id to build the subject structure
and holder
which Is in conflict with an r applicable Home Owners Association rules,bylaws or a for that may restrict or prohibit such
structure.Please consult=your Home Owners Association and review your deed or 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
improven)gnts to your property.A Notice of Commencement must-be recorded and posted on the jobsite
before W first inspection If you intend to obtain financing.,cogodsi wit Inder or an attorney before
of Com t�
cam cin wodwr reco�ding your Notice mencern"'it.
Sign re /Owner/less ffiegenSign
J1- - N df Contractor/License
STATE OF FLORIDA, Rfter-
10 TIE OF FLORIDA
COUNTY OF_ I)LKPC�.jt� COUNTY'OFST LIXTE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 2Tday of6 �V- , 20 1s'_by this 'D day of ooTo'm 20 1 f by
ROBERT LUDLUM
(Name of person acknowledging) (Name of person acknowledging)
(Signature of.Not#Publivitate of Florida) (Signature of Notary PubIV.*ate ofolorlda)
Personally Known OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Prod C ... "ERTV rpe of Identification Produced—.
R!
Commission No. MY, I 61ON 41 EE8642)t)M Mission No EE=92 — -----
M
IEXF�II ES January 08,2()lR
l
HONDA LAf:FERTY
V1,00rxV` F_XPIRE8 January 08,2017
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW, REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS