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All APPLICA LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED // f Date: J Permit Number: / 69 RECEIVEDREFURM VISION Building Permit"Application NOV 2 9 2016 Planning and Development Services PERIVIITI'ING Building and Code Regulation Division St. Lucie County,FL 2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: P•�O 'O� � N ' RSO E EN O 10 Address: _ .2 A,7 W a c,LL i Legal Description: Property Tax ID#: --,q- 2 -3 000 1 -0 yd !-F Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: /e p L « • • • «O �T • FO' TI© Additional work to be pertormed under this permit--check all that appy: _Mechanical _Gas Tank _Gas Piping Shutters _Windows/Doors _Electric _Plumbing _Sprin _Generator _Roof Pitc Total Sq. Ft of Construction: Sq. Ft.of First Floor: Cost of Construction:$ -utilities: —Sewer. _Septic Building Height: 0apillCONT' OR: ;Name rko 1. :�� u� Name:_ ' 4 ti; c.u�r22iil Addr"ess: =rO.t� da.�' �JJa��nra�n� AW Company: +tri z `' rvc i� o v - ,ate City: State:-C_ Address: Zip Code: 3V 9 U Fax: �! City: )0 Y 'State:-.E:,/- Phone No. 772, 3 '��3 / Zip Code: ;� SL y�� Fax: E-Mail: a o Phone No -7 7 2 - 3 .S g- 0 9,2- Fill in fee simple Title Aolder on next page(if different E-Mail 54-a ti-4,.e m c- h 3g 6 @ 6 from the Owner listed above) State or County License O If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.