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ALLAPPUCABLE INFO MUST BE COMPLETED FOR APPLICATIORI To BEACCERED:' e
Date: �1��'� 1�� Permit Number:
� CCE1VED
Building Permit Applieathm S E�P 17 ,-j l8
Planning and Development Semices ST.Lucie County, Permitting
Building and Code Regulation Division '-
2300 Virginia-Avenue,Fort Pierce FL 34952
Phone:(7721462-}553 fax:(772)4621578 Commercial :Residential
PERMIT APPLICATION FOR: To Select from dropbox, dick arrow at the end of line; 5�`\V �S
y 5 S' a+c SU"C+cC s �.. +s �.r i,=E_ .vf {� S4aL� Enda 1 � L ,� ac4 w'3' +( a,£.w' .� �+ �� .'`u*� ✓.
Address.- t l Le 00- EN Me S �� �<. 'i �rC ��
Legal Description: U-)0C>-i 6)K -D'L
(rY74t 3 1 I jr4 X a(2 -9'6--3 -,-�2
Property Tax ID#: 6D t- &D( -C7/03 — Do 0—'-1 Lot No. -q
Site Plan Name: Black No. !
Project Name:
Setbacks front Back: RightSider LeftSide-
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3 � � � Y�rcl~,,I-i�ura-P Sl��rt�ls? r�-F S�S�I.e►�
njinon in►or to un t permd-c app y:
LtHVRC _has Tank fleas piping _Strutters �WirrdavusjBoors
L_lEtectric -PlumbingSprinklers El&enerator `_hoof /� Roof pitch
Total Sq.Ft of Construction: kp S
Ft.of First Floor.
Cost of Construction:$ -/ �' UfiGfies:L=1Sevuer Septic Building Height:
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Name P r'r l'V- Narne: Jet--FI-eL( Pa r'i pC
Address: "7 teDZ j A rn.P S Company: tLA;C,4
City- JF-�,r4- p -C r c C_ State:It- Address: !0113 SU) S�SU, MQ GV -
Zip Code:_3��� ) _ Fax:. City: State.
Phone No.r?r7a - 33 2L— d r7 L( zip Code: J Yq&Y Fax: -7 -a or7--735'j
E-Mail: Phone Ilio.. '1701'3 L1 L4- r7 t-3
Fill in fes simphE 7tle H41der an nerd page(if cliff r,t E-Mail: ue 0
ftem the{hnraaer listed ahov4 Stat$ar Coucity l icense' C l
Jf value 4f arstisnr is$2500ormux-e a RI C0RD€0X of Camnrre acelnr_nt isms s1,
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t:�-,.9e;=Sri s���„ fes.
OES(GNERj(t _Noti 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: Gh►:
Zip: Phone: Zip: Phone:
OWNER/CONTRACTOR AFF OVIT;Application is herebymade to obtain a vermit to do the work-and gismIlatian as;indisatedr
I certify that no work or installation has commenced prior to the issuance of a permit.
St-Lucie County makes nv representation that is granting a permit will authorize the permit holder to-build the-subject structure
which is in zmntlict with any applicable Home Ow_riers Association rmles,bylaws or and covenants#hat—m rEe-Wjct orprohibit such
structure.Please consult with your Home owners Association and review your deed for any restrictions whid>I inay aPPiY - -inconsideration of the granting of this requested permit,i do hereby agreethat i will,in all respects-,perform the work
irr accordance with the approved plans,the Florida Building Codes and-St Lucie CountyAmendments.
The following building permit applications are exempt from undergoing a frill concurrency review:room additions,
accessory stn mctures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non4esidential use
WARNING TO OWNER:Your failure to Recorda 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.
Signature of Own--J”Lessee/Contractor as Agent for Owner Signature of C ctorf License Holder
STATE OF FLORID STATE OF FLORID
COUNTY OF r t? CA COUMY OF
The#argaing instru ent was acknowledge iefore me Ttie forgoing instrume w acknn��efore me
this f day of 201K by this 114 day of Sr6R20 by
CtQ�-ICt� Gi
Name of person making stat ment Name of p rs alcings ent
Personally Known,t-� OR Produced identification Personally Known V ORProducedidentification
Type of identification Type of Identification
Produced Produced
�O
(Signature of NotarPub (Signature of Notary Pubic tate of Florida
liagwetdeSS3Cdrnml55l6ri N6. tsstww � w: Commission No. CONSTANC phi ll X
xinOa w MY COMMISSION#FF 160517
d 3DNV.LSNOO
+ !: '-'.';;o:�'t,O EXPIRES September 16,2018
122039"153 Flor Motaryservioe. m
REVIEWS FROM ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
BATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17