HomeMy WebLinkAboutBuilding Permit Application c
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Q l�
Date: `1`.� �� Permit Number:
�' r3 itEG�1V.CD.
Building Permit Application A au 1a19
Planning and Development Servicesperm;ttin9 u paa tt�e�r
Building and Code Regulation Division - st.
2300 Virginia Avenue,Fort Pierce FL 34982 /
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential V
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPR`OVEMENTIOCATION
Address: lLooj
Legal Description: L nk-e to YYYJ -PGy, k- nii--1— 6,1x--19
tc�c� 1 Q51�
Property Tax ID 4: Lot No.-C93Q
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF*WORK:
i0 x 10 .S[-ed , ICc-ty Ic On SoI,I
CONSTRUCTION',IN FORMATION:
Additional work to be erformed under this permit—check all appy:
HVAC .Gas Tank F]Gas Piping _Shutters Q Windows/Doors
11Electric 0 Plumbing []Sprinklers E]Generator 1:1 Roof
Total Sq. Ft of Construction: I0C) S . Ft.of First Floor:
O' + I,
Cost of Construction: $ �+ 9-71 - 260 Utilities. _Sewer Septic Building Height:
OWNER/LESSEE:-, CONTRACTOR
Name VY" MY i C1 n "DO 1(eV_ Name: Tom Saurey
Address:-R OI 1'c' As\l_ Company: Tuff Shed, Inc.
City: ace State--t7 Address: 8524E Colonial Dr.
Zip Code:1�_ 1iIF; I Fax: City: Orlando State:FL
Phone No. 0 , Zip Code: 32817 Fax: (360)998-3228
E-Mai : C l Plhone No. (407)985-2990
Fill in fee simple Title Holder;on next page(i dtuffshedifferent E-Mail: @Permit-it.com
from the Owner listed above) State or County License: CBC1253645
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPFLEMENTALCONSTRUCTION LIMLAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Richard Wills#76835 Name:
Address: 1777 S Harrison Street Suite 600 Address:
City: Denver State: co City: State:
Zip: 80210 Phone: .(303)753-8833 Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: X 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, co It ith lender or an attorney before
commerWing work or recording our Notice of Commencemen
S
g ature of Owner/Lessee/Agent Signa 're of Contractor/Lic ns er
STATE OF FLORIDA Q � ,(�f/Q STATE OF COLORADO
COUNTY OF ��/ : /l/(/t�l//'C/ COUNTY OF DENVER
The for ggin�g� instrumgnt as acknowledge efore me The for oing instrument was acknowledged before me
this:'day of 20 �by this�a of March ,20 18 by
&JI)d170fi Tom Saurey
e ofperson ac ovule ging) IN f person acknowledging
( natu o ry Pu tic-State of Florida) (Sl ature f Notary Pub' -State of Colorado)
Personally Known OR ProducedIde ification Who is personally known to me and did not take an oath.
Type of Identification Produced
SC�f—
* (C®mml0l0n Commission No. Seal#GG 198139 20024017819 (Seal)
Commission No. g a S�ti 46 March 20,2022
Off��P` Bonded Tlw Budget Notary Servces
STEPHANIE Ell IT,.-- Ii
NOTARY PUBLIC
Revised 07/15/2014 STATE OF COLORADO
NOTARY ID 20024017819
N EXPIRES OCTOBER 11,2021
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE GROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS