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Building Permit Application
ALL APPLICABLE INFO MUSr BE COMPLETED FOR APPLICATION TO BE ACCEPTED � 71 Date- ! t'` ' 17 Permit Number: e Building Permit Application DEC 2 2011 Planning and Development SeWces Building and Code Regulation Division 23W VirginiaAvenue,Fort Pierce FL 34992 Phone:X214621.553 Fax:(772)4621578 Commercial Residential PER IT APPLICATION FOR: To Select from dropbox, dick arrow at the end of line -PROPOSED IMPROVEMENT LOCATION: Address: \_ Port St.Lucie 34952 Legal Description:part of 3414-507-1701-OOM-.Spanish Lakes One Property Tax 1D Lot NO. _ Site Plan Name- Block No. Project Name Setbacks Front Back: RightSider Left. de; RETAILED DESCRIPTION. -OF WORK: Demolition of mobile horrie , CONSTRUCTION INFORIIi'IATIOI : AdditionatworIctobepe o £rmed under this permit—check a appy: [JHVAC L i Gas Tank E]Gas Piping _Shutters �Windows/Doors F_JUElectric O Plumbing Sprinklers Generator 0 Etoof Total:Sq._Ft of Construction: SQ.Ft.of First Floor Cost of Construction:$ .` Utirdles Sewer Building Height: OWNER/LESSEE: CON f RACTOR. Named Bttildtng+CaMorallon Name: Matllteusi We VVYnne Address:8000 South US 1•Sine 402 Company:V"Development Corporation City. F'oft St.LucieState.- Address: 8000 South US 1,Suite 402 Zip Code. 34952 F=772-878-0224 may. Port St L.ude �:F'•� Phone No.772-878-5513' Zip Code: M5 Fax 772-878.0224 E Mail:sue@ +etrc-c n Phone No. 772-878-5513 Fila in fee simple Tate Holder an next page(if dfffbrertt E-Mail:sueglwynnebr-com firom the Owner Uste+d .above) State or County License: CGC.A35999 if value of construction is$25W or more,a RECOMED Notice of Commence-meat is required. r � SUPPLEM,IENTA CONSTRUCT ION LIEN LAW INFORMATION: DESIGAER/ENGINEER: Not Applicable MORTGAGE COMPANY: � Not Applicable Name: Name: Address, Address: City: ' State: City: State: Zip: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER Not Applicable BONDING COMPANY: Not Applicable I 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 Cauny makes no representation that.is granting a permit wig authorize the it holder to build the subject re which is in.conflict with any applicable ble Home Owners Assoaation rules,bylaws or a�enants that may resMct or pr i6it such structures Please consult with your Home Owners Association and review your deed for any restrictions which may app . in consideration of the granting ofthis requested permit,l do hereby agree that I will,in all respects,perform the wo 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,s4pL%screw►rooms and accessory uses to another n i use WARNING TO OWNER:Your fail Record a Notice of may re It mn rtg tw1kce far improvements to your props .A NoticEe f mmencement must be recorded a st an the jabsite before the fist inspection. au intendbtain financing,consult with lend n att trey before carrimenci work or re i our o€Commencement s Signature.of owner/tessee/Agent Signature of Contractor/License Holder a STATE OF FLORIDA. STATE OF FLORIDA COUNTY OF mt—ro COUNTY OF sL ulde The fo Ing instrument was adamwiedged before me Theforgoing instrument was acknowledged before me th of .~ti r. 2t?ljby *6 ay i �"�`��Zia V-) by MamrewLy�Wymee Matu,Ewtylevymne (Narrre of p acknowledging.} {Name of person acknowledging Sfgn a of Notary Public-Staie of Flo ' } re of Notary Public-5 o U) Personally Known x OR Produced Identification Persc ally Known x ORFu identification Type of Id Pm c Type of Identification Produced ts;Y np�, i SUSAN MAGEE Commission No. :�: COMh91SS1(1SM87647 Comas SUSAN h4AGEE 11) U-- "f n= EXP RES:February 23,2019 :,; ,,: MY COP1MtSSiON#FF 187647 :o�''o ©ondedThmNotazyPublicUndemriters Vii'., EXPIRES:February 23,2019 cy,RfSaBonded laru Nolary Puo Revise 0713.512014 REVIEWS FROM' ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS