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ALL APPLICABLE INFO]MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �f �✓ L Permit Number:
Building Permit ApplicationPlanning and Development ServicesFloe,
Buiilding and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED`IMPROVEMENT LOCATION`
Address: y�N C-1geE
Legal Description:Gcenu:�� EAl = 1 ( 04-_5 (0-99 AQ'
Property Tax ID#:c'>-1 a1 --10+- C00-I -COD—a Lot No.
Site Plan Name: Block No.
Project Name:MjCmlcjCl.pc' ' I I
Setbacks Front Back: Right Side: Left Side:
&2(LED=DESCR'I. TI
PO.NOF WORK-
b&2
Ia X I a Shed , nD elm -�►c�j
- o n C.Q
CONSTRUCTION?_INFORMATION:
Additional work to be nertormed under this permit--check a appy:
HVAC 11 . as Tank ❑Gas Piping _Shutters O Windows/Doors
Electric O Plumbing OSprinklers O Generator 12 Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction: $ Utilities:In Sewer O Septic Building Height:
OWN f R/LESSEE: CONTRACTOR:
Name C /I 1:-:'L.� ,4t C_ Name: Tom Saurey
Address: L1 4 4, Lf Company: Tuff Shed, Inc.
City: FQ h--r State: Address: 8524 E Colonial Dr.
Zip Code: LI?Z Fax: City: Orlando State:FL
Phone No. c( S`t" '7 Zip Code: 32817 Fax: (360) 998-3228
E-Mail: Phone No. (407)985=2990
Fill in fee simple Title Holder on next page(if different E-Mail: tuffshed@permit-it.com
from the Owner listed above) State or County License: CBC1253645
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUP PLEMENTAL.;CONSTRUCTION LIEN,LAW INFI R-MATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Richard wills#76835 Name:
Address:1777 s Harrison street suite 600 Address:
City:-Denver State: Co City: State:
Zip: 80210 Phone: (303)753-8833 Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable BONDING COMPANY: X 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,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 fir tion. If you int nd to obtain financing, cons It with lender or an attorney before
comme, F gwork or ecordin u Notice of Commencem t.
J_�� L'__�l
S
_ ignature of r/Lessee/Agent Signature of Contracto icense Holder
STATE OF FLORI Dk STATE OF COLORADO
COUNTY OF � .i COUNTY OF DENVER
The forgoing instrument was acknowledged before me Theinstrument was acknowledged before me
this ay of i I 20
ISthis .jrging i
ay of March , 20 18 by
Tom Saurey
(Name of person acknowledging) (Name of person wledgin
I 4ALJ
t e of to Public-State of Florida) (Sig lure f N -u r -State o Colorado)
Personally Known OR Produced Identification Who is personally known to me and did not take an oath.
Type of Identification Produced
$TACEYJOSEPH
pm"iSsim#GG 198139 2 24017 PHANIE 54
Commission No.EIC�J� S13 1 . (�`ea Commission No. B I�
N res March 20,2022 N ARY PU
OFFL�P\C 8oMedTlruB*etNotary swkes STATE OF COLORADO
Revised 07/15/2014 MY COMMISSION IAK
EXPIRES OCT06ER 11,2021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS