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ALL APPLICABLE INFOMUSTBE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
RECDED
I
Building Permit Application oCT 1610
Planning and Development Servicesm ent
Building and Code Regulation Division Per 5 rtm0 co"
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential _
PERMIT APPLICATION FOR: Shutter
PROPrOSED IMPROVEMENT LOCATION{ s n E..�`S 1',k._
Address: V1 N rk MAIL 6R-,V-F-
Legal Description:21,511 0_0() 0O&J ODD-3 �
Property Tax ID#: A101 '5b0 !3063- 6 v Lot No.
Site Plan Name: F,t,u� Whi�T Block No.
Project Name: '13F`T/-(
Setbacks Front Back: Right Side: Left Side: !
DETA�ILED�DESCRIPTIpN OF�'WOFtK r ti Y r , ,` _ ;� ;>�
rr P-/+AJUS.
CONSTRUCI"ION INFORMATION t.. . `; a.> µ`
Additional wor to nrformed under this permit—check all appy:
HVAC Gas Tank 0Gas Piping Shutters ❑Windows/Doors
Electric ❑ Plumbing Sprinklers _Generator Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: Utilities: Sewer Septic Building Height:
OWNER/LESSEE y CONTRACTOR ;
Name F_LJ7.qr3Crg LJ14FEg NameFi ickoe' - ,z fNr77f
�1n�-
Address: Y6 JV - r1ig2 helve- Company: AS70LCf4 eF �lltt`77r� �°Q
City: JE"SIFN '-13E14@Gf State: Address: )d-q 9 b JE SUTAt lNp- b 2J Vr:,
ZiCode: ax: Cit
p c3'y y: )40136 J 15 UN K) FC. State:r-11-
Qom/
Phone No. Zip Code: 3 345r' Fax:77 '5 y123�47
E-Mail: Phone No. 77,z-5w5-33 bo
Fill in fee simple Title Holder;on next page (if different E-Mail:
from the Owner listed above) State or County License: �+
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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IE--,'C N -0
EM IE
STRUETI N11
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:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Count 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 ancovenants 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, consult with lender or an attorney before
commencing work or recording your Notice of Commenc_enzQnt.
Sint.6re of Owner/Age - tignature of ontractdr/Llcese Holder
STATE OF FLORID,, STATE OF FLORIDA 'p
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COUNTY OF COUNTY OF j��VVN cc 'U,
U ON The forgoing instrument was acknowledged before mem d N The forgoing instrum t w s acknowledged before E2
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C13 this 4!J of 20 by
this -;-Zidayof 26, by 00 o-i day CD a: :S
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(Name of n �ys"0 0
,a/c n ledging) (Name of person ackqowl 4dging
(Signat Notary Public-State of Florida (Signature of Notar P Ii St e of`F7670-7—
u ot
ow
Persona7llKn n OR Prod ed Identification Personally Known OR Produced Identification
Type of Identification Produced 1 Type of IdentificatiMProduced
Commission No'/"C-o-- c 2A L— (Seal) Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS