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STORM SHUTTER
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: /0 �L� Permit Number.: RECEIV Building Permit Applicatio OCT IL 5 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)46271578 Commercial Residential PERMIT APPLICATION FOR: 14 CCS 12S try PR©POSED IN'P. ©&E))MEN Lt7CATl®N: Address:J IUO Holel a. cocee 0/' P:tice iFl 3 V 9 l Legal Description: Cora COVt Oe,-&A Xr-C. .epoe, T-4A{ jovilo'lf �Oregir--/ /f ,ole '6 H,-o-4a- Cerre uk%4 P MPAa f aMe-IA***et e� Property Tax ID#: /q Z-57-- 701 - C o Lot No. Site Plan Name: /�1i4 / Block No. Project Name: Setbacks_- Front Back: Right Side: Left Side: u DETAILED DE�SCRI�PTI®N e'F WOR+f<: /�cfc✓ivr� �c4�H7 .PRri e�io �orh� C®IlISTR<,IJCTleN l'NFORMATf®N: itional work to be per-tormed under this permit-check all that appy: _Mechanical _Gas Tank _Cas Piping Shutters _Windows/Doors _Electric _Plumbing _Sprinklers _Generator _Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cost of Construction: $ S-00 ° " Utilities: —Sewer _Septic Building Height: �30� ®1NNER/LESSEE: CONTRACT®R: Name r/orn G o- A s Name o f"91 Address: o?�I 6r �or vc Company: City.- _f e4S e✓e e State: 01c�'/ Address: .2 3 cs Zip Code:.3 q!2 !j0/ Fax: G efA City: �S_trC r. / Statep: Phone No. vol- 9 y7- 9'7s7 Zip Code: ,? Vg!i�4 Fax: e( E-Mail:_ AIA Phone No. 7;72- Fill .2 Fill in fee simple Title Holder on next page (if different E-Mail: O d C (W 4,1oo,l d w? from the Owner listed above) State or County License:SSL C' 1,7//<Sf O e? If value of construction.is 2500 or,more,a RECORDED Notice of Commencement is required. - SIJPRl.EM,ENTAI.C®'NSTR` CTI®N [. EN I.AW IN.FORMgTIQf�:: FAMEMM. 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:p.rohabit such Horne structure. Please consult with your Hoe Owners Association and review your deed for any restrictions which may apply. In consideration of the graritirig of this requested permit, I do'herebyag�ee that l•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 our Notice of Commencement. Signature of Owner/Agent/Lessee Signature of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA COUNTY OF COUNTY OF The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of 20_ by this day of 20_ by - (Name of person acknowledging) (Name of person acknowledging) (Signatu,re of Notary Public-State of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification Produced Type of Identification 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 _11-ev.