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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
Building Permit Application DEC a 2W7
Planning and Development Services
Building and Code Regulation Division
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2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: Oei,,o1,"f%oh � ! ;
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PR PQS:ED INPRQ :N LC�CA�T10' t:
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Address: /070/ Syleun Ar. JA� ��°�� >�L• �3'�9�7-f�'���i
Legal Description: Ve41z rj 01,, "See-1m9 G' `fit l0 7
Property Tax ID#: yJ��� 'yo - 0/07"000Lot No. /07
Site Plan Name: An/w/f Block No.
Project Name: 740d
Setbacks Front Back: Right Side: Left Side:
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will
778 SAC,
AdclCQ�N5°�TR,l1�C�TI,O.N, I ®�i;M'A�TI
itiona,wor 'to a per orme under this permit—check a thatappy:
Mechanical Gas Tank —Ga`s Piping Shutters I: ' -Windows/Doors
—Electrics.. _Plumbing —Sprinklers "_Generator i:; _Roof
Total Sq:ft=of'Construction: /90�• b Sq. Ft.ofjF'irst Floor: !79
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Cost of Construction: $ .�St 779 Utilities: Sewer —Septic Building Height:
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Name ✓I 4//e2 //
Address: 1'93 t"r4rl4All Company:
City:_841/d# - State:)O1 Address: ��� ,iJl�:�,S.�eh�e� f7�-
;Zip Code: D7 y0 Fax: City: ,7-o_<eA State: �
Phone No. 772-,77-7-5177 Zip Code:_39W47 I Fax: -.2-32-2/9/
E-Mail: Phone No 77,�_'' ,?jl d 471f
Fill in fee simple Title Holder on next page if different E-MailS/2g4ew . cam
from the Owner listed above) State or County License 12-RC/23/f8/
Evalule of construction is 2500 or more,a RECORDED Notice of Commencement is required.
SU'PPLE� ENTAL CONbSTR' CTION LLEN LAW IN'.':.'®'RIUTATI®'N
DESIGNER/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
Name: Name:
Address: Address:
City: City:
Zip: Phone: 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or r.gocording you_r-Uotice of Commencement.
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Signature o Owner/Lessee/Contractor as Age for Own r Signature o Contractor/License older
STATE OF FLORI =LLQ STATE OF FLORIDA
COUNTY OF _ COUNTY OF
_�K
The fyrp instrument was acknowledged be gg The for oing instrument was acknowledged be, �i
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thi day of�L(Q C ,20J b gperp¢ .9 this day of,J�r. ,20f�'b I�g
¢>W a oo¢ 2
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(Name of person acknowledging) (Name of person acknowledging)
:�• 4 .6
••*;fid,
(Signature of Notary/lic-State of Florida ) (Signature of of y Public-State�of Florida)
Personally Known OR Produced Identification Personally Known / OR Produced Identification
Type of Identification Type of Identification
Produced Produced
Commission'No. (Seal), Commission No. (Seal)
REVIEWS FRONT ZONING . SUPERVISOR PLANS VEGETATION . SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 7/2014
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Planning&Development services ASBESTOS NOTICE
Building&Code,Regulation Division
2300 Virginia Avenue i
FortPierce,FL. 34902
Phone:(772)462-2172 Fax:(772)462-6443
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Asbestos Notice to Contractor
December 28, 2017
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ADAM SMITH BOBCAT SERVICE INC
ADAM SMITH f
661 NE SPENCER ST
JENSEN BEACH, FL 34957 j
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RE: Building Permit Number 1712-0688 �!
It is your responsibility to comply with the provisions of Section 469.003, Florida'Statutes and to notify the Department
of Environmental Protection of any intentions to remove asbestos when applicable in accordance with state and federal
law.
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I Signature
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Date
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12/28/2017 12:28:29 PM I j