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All APPLIC BLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �5
Date: Permit Number: I li
j RECEIVED
•
- Building Permit Application
APR 112019
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE: A . 6ayve,
I
PROPOSED CNPROVEMENT LOCATION::
Address: 9-U[_!�
h O k ay L Ale- ) Un i 11 (,0r00 f C*P—d ts1 . ,Cp i CPQ C.PP
Property Tax ID#: 14IS "162, 10 �-1 7 - L f Lot No.
Site Plan Name: Block No.
Project Name:
._s", ,
DETAILED DES,CRIFTION OF WORK
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-��'U�t In LI✓�2� -rw N L
',CONSTRUCTION INFORMATION:
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Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor: y
Cost of Construction:$ 2), 20 0 Utilities: —Sewer —Septic Building Height:
0 NER&ESSEE. CONTRACTOR
Ndfrr
e�(P-1D LQ'(1(l '�'( St.. CGS ame: �C7 4'li� Ste-)-�a(1...
'e o �,rT,e S �n�• Ig31 CordoJa P_D3 Company:_Com ) S O
Ass: -r-
City: Ft Ln gdeydcA I e__ State:_T-L Address: kO StiJ
Zip Code: 33N Lo Fax: City: State:
Phone No._015`4-2,1q ' 9 4-2). Zip Code: 17 0(�� Fax:
E-Mail:� (L`,S�Lj)QQDMCCM,rr1 Phone No OLS-Ll Sloes
Fill in fee simple Title Holder on next page( if different E-Mail lL L Q` a`0.!3A Com'"'
from the Owner listed above) State or County License C A-C-0 S-1-73 0
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required.
S'OPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
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 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 befecorded and posted on the jobsite
before the first inspection. If yo intend to obtain financing, consul wh lender or an attorney be�Q1wl;11i1i►ej���
commencing w or[9c_ordinjJVour Noti enceme t. ���� L,YN
61012,26,
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Sig ture of ne ee/ #tractor as-Agent &P Signa u ractor/License Holder
fs d 2:,y #FF 991630 '
STATE OF FLORIDA _ AT F FLORID q % o •°�
COUNTY OF 0° u� vi "� 9•of ®�ded ;
_ COUNTY OF l�`c��can� i �i •.���iFii.�d�•:.. .
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G, EThe forgoing instrum nt was acknowledge befo The for ng instr ent was acknowledged bef6N4;�i,,M'������`
thisC day ofJ 20�by this�`b�day of r� 20 by
O ovl "�cl v X• '` �0hn
Name of person making statement. `s. Name of person making statement.
•`�'�Vis'
Personally Known OR Produced Identifi Personally Know OR Produced Identification
Type of Identification Type of Identification
Produced dr - Produced
lift r
(Signature of Notary PuW--State of Florida) (Signature of Notary Public-State of Florida)
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.