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APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: J0 Permit Number:
RECEIVED
Building Permit Application AUG 17 2018
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, permitting
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
PROP5
"W 01 E bc
9� J` P ti A) -5
Address:
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Legal Description` -_LA4K_L,5'_ W00 _1__> I< H-0- L-0-6 d40 0,156
Property Tax ID#: 1961. (o 0 1 - QQ 3 6 ar)6 - I Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
�DE $
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_000 R_J 190,517e_ Cl-ap?,
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Additional work to be nertormed under this permit-check all t1l.at apply:
HVAC. Gas Tank Flas Piping Shutters 0 0 — (Windows/Doors
FlElectric M Plumbing FSprinklers F]Generator F] Roof
Total Sq.Ft of Construction: Sq. Ft.of First Floor:
- - —_ — - 13 (0--7:77 lit —1 Sewer F�Septic Building Height:
Cost of Construction: Utilities:
-WEMt0s WkwdT -N
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Name_L.A� [A� )q- Name:
Address: O -J_e_1L)AJiA.)V,.5 (4 &M
Company"—
City: c-- r y?i diw_a e, ate: 'f-L- Address: 0,� 4 U i 41
Zip Code: Vq5- I Fax: City: 1, - ih k 4,_ state:
C
Phone No. �9, - qG 37 '7 Zip Code: .SLI 1 Fax:_514
E-Mail: Phone No. 5-Le
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: 0 C, C,F c ~5 z
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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5UfP�t.EMNrIsCCfU5TRUCTION MIEN LAUIfrlNFORMA all, N
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
r` 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:
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.consuIt with-your-Home-Owners Association an'd`r`eview 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 roams 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 our Notice of Commencement.
o✓S- s
_Signature of Owner/Lessee/Agent SI ure of Contractor/License Holder
STATE OF FLORIDA STATE OF FLO�% ,e
COUNTY OF0COUNTY OF
The f Ing instr ent was cknawledged before me The forgoing instrument was acknowledged before me
this day of 20 Z-by this_Z�5 day of !J 20 tr_by
(Na a of persona nowledging) (Name person acknowledging)
- 1
(rrson
re of No Pub[ -State of Florida) (Signatu of Notary,Pub/lic� to of Florida}
P now OR Produced Identification Personally Known OR Produced Identification
Type of IdentificationProduced-DLiiCL, Type of identification Produced
Commission N ission No. (Seal)
*ftP�blic �of Flor a �b� •••.�r� ANGELA YOUNG
Notary ° * MY COMMISSION k FF 951069
Fernan es
� '"V[ rj*,j0FjcpiCresrMnOi 30!2021 y 110630
9r� ��,aEXPIRE$:Apri142.2020
Revised 07/15/2014 'rP barged ihruSudgetNotary Serrices
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS