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ALL APPUQA '-L sT BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: Permit Number:
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7 Building Permit Application
Planning . . Developmentservices
Building I I -ode R-1 I I Y
2300 VirginJ4Avenue,Fort '
Phone:(77 fax-(772)462-1578 Commercial Residential
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. e Title Holder . different
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DESIGNE1NEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name: _
Address: Address:
CityState: City; State.
Zip: Phone: Zip: Phone: '
FEE SIMPLE ITLE HOLDER: _Not Applicable BONDING COMPANY: —Not Applicable
Name: Name'•
Address.• Address:
City: City:
Zip: Phone:_ Zip: Phone:
1 certify that nc work or installation has commenced prior to the Issuance of a permit.
St.Lucie Count !make no representation that is granting a permit will authorize the ermit holder to build the subject structure
which is in con ct with anYY pplicable Home Owners Association rules,bylaws or andpcovenants that may restrict or prohibit such
structure.Pleas consult wit your Home Owners Association and review your deed for any restrictions which may apply,
In consideratior of the granting of this requested permit,I do hereby agree that l will,in all respects,perform the work
in accordance w th the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The following b tiding permit applications are exempt from undergoing a full concurrency review:room additions,
accessory struct ires,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNINGT( OWNER:Your failure to Record a Notice of Commencement may result in your paying twice fpr
improvernerr to your property.A Notice of Commence ent must be recorded and posted on the jobtite
bef a the fi t inspection. if you 'mend to obtain fin: ,consult wit lender or an a torney before
cam encin din r Notice of Commenc ent.
01 WA
Signat re of y e-e Sig ure o Co tra ce se Hold
STAT' 0 IRIIIASTA E OF o
COU O COU 01= . �.
The f going in tr ll was acknowledged before me The forgoing instr t as acknowledged before me
this day 20 14Lqby this„(',day of 20_LAtby
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(Name of so acknowled ng) (Na f per00 acknowledging))
ignature of Lary Public-State of Florida) Igrlature of Nbtary Public-State of Florida)
Personally Kno n k4hl !i Personally Known
V�l,l ill„ '
Type of Identifi at, n ' �y Type of Ident!ficatlon Prod a tilt°Lo'' FRAlndLP=k I .
Notary Public-9iate of Florida 5 Notary Public-State of Florida
Commission Nc comm(%RPj�s Jul 22,2017 Commission No. r. hf> )n.Explre§Jul 22,201
•+, r:' �' ;: , `�'� Coxlmis.;ion#
FF 038392
II •„��,;;�o,r Col mission#FF 038392
Revised 07/ 5/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE I.
COMPLETE
INITIALS