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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
41d7 ) 1-80>11 - 04-27
Date: 4, 11. Permit Number:
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Building Permit Application APR 17 zoi8
Planning and Development Services
Building and Code Regulation Division Permitting Department
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial 114s& t�ycWlZounty, FL
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PRfi}POSED IMPROVEMENT
Address: 935T 510 &Ub, At— LM-?qb
bUT MRiV, OAJIT
Legal Description: c S - H 5116 RE-
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Property Tax ID#:-4,41,26 Yb 7-bb 23 1166 Lot No.
Site Plan Name: Block No.
Project Name: PIUM AWN
Setbacks Front Back: Right Side: Left Side:.
DETAILEDN'OF V1lORK:
CONSTRUCTIONz.
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Additional work to bFI
rtormed unTe-r-t-Fis—permit-check-a-ff-tlm-tappiy:
F\711 E
-]Gas Piping L&_Shutters utters
F]HVAC GasTank F 11 Windows/Doors
FlElectric F-lPlumbing E]Sprinklers FIGenerator F] Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ Utilities:FISewer EiSeptic Building Height:
OWNER/LESSEE
Name IAUNA R&blN Name: M16Hi9F-A- ZAA)&-ftf
Address: 1)3T(? ISO HaMb toz,?1b61C_ 73V_yh Company:p))qS7WWf SMC7'7K ftP
City: PRIJ)I a-(C/ State:' Address:- 1-2qeO JC- 31t7J4AJR)P, b&VE-
Zip Code: c3/fqqb Fax: City: AMB 501W6 State:
Phone No. Zip Code: 33_11f Y_ Fax: 3 q 7
E-Mail: Phone No, 7 12-
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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'S1 RucndK�LIEW W-INFORMATION
,
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
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Name: Name:
Address: Address:
City:— State: City: Phone: State:
Zip: Phone: Zip:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: 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 first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording your Notice of Commencement.
X?�A-C;)v :Z�Lo� A CAKCs
-Signature of Owner/Lessee/Agent S7ig`n_atJre of Con ra701_iens Holder
STATE OF FLORIDA ll STATE OF FLORIDA WV_0
COUNTY OF d.L4C� P COUNTY OF ?tkL—
The forgoing instrument knowleclgecl,�efore me The forgoing instrument was acknowledged before me
this/Eclay of 20 i-Lby thisil-dayof 20�by
/7
(Name of person acknowledging) (Name of person acknowledging
2,2
(Signa re of Notary Public-State of'Floricla) (Signature of Notary Public-State of Florida
Personally Known OR Produced Identification Personally Known _-�®R_Produced Identification
Type of Identification Produced Type of Identification Produced
o% Notary ublic State of Otftrn !on No. Se
Commission No.GG/,57/33— 4� Rozanne Marie Glo OWSKI
My Commission GG 1 7136 CK
N MPF
re�'z�STEM' r � I
ry-res 11101.12021 ;11
EXpRZES:MffcWh30;,2i062i0
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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INITIALS _J