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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 0 )
Date: •S — Permit Numbe : --p 10�/
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Building Permit Application FEB 5 2020
Planning and Development Services Permitting Department
Building and Code Regulation Division St. LLlCIe
2300 Virginia Avenue, Fort Pierce FL 34982 U n t)!' FL
Phone: (772)46271553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSEDIMPROVE_MENT LOnCATIONMI
Address �fi. C1poI'� k)Iv 1. Lc+Q0 I
gDescription:tel f i a Grp V, Gn-•�Q I'-1�Q'l�- b 1 )0 c. r nl
Legal
Property Tax ID#: +Hs2,-!� - I Lot No.
Site Plan Name: 1-Tips m Block No.
Project Name:_4-rL3ShCr-)
Setbacks Front Backi BackRight Side: Left Side:
DETAILED DESCRIPTION OF-..WORK
I N 0 Yf t 4-G-} 1'Y 1 I
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CO NSTRUCTIONINFORMATION
Additional work to be performed under this permit-check a app y:
HVAC 0 Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
11 Electric 0 Plumbing OSprinklers ElGenerator Roof
Total Sq. Ft of Construction: &I S . Ft.of First Floor:
Cost of Construction: $o� �� •L�� Utilities: _Sewer Septic Building Height: �Q
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Ow-NER%LESSEE CO.NTRACTOR
Name ayl _tffi l Name: Tom Saurey
Address: 5'.ue-j!! [2:�j1y91 LQQ+ QL0 Company: Tuff Shed, Inc.
City:' -E- -ecoz? State: Address: 8524 E Colonial Dr.
Zip Code fa�TJ( 12 Fax: City: Orlando State:FL
Phone No.gy,-;3, Zip Code: 32817 Fax: (360)998-3228
E-Mail: j!tj fnt Phone No. (407)985-2990
Fill in fee simple Title Holder on next page(if different E-Mail: tuffshed@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.
�;SUPL,EIMENTAL CONSTRUCTION LIWN W
PINFORMATION::
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: RchardWills#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 TITLEHOLDER: _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 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 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, consult with lender or an attorney before
commencing work or recording our Notice of Commencemerlt. ,
s
_Signatu of Owner/Lessee/Agent Signa ur of Contra /License Holder
STATE OF FLORIDA STATE OF COLO
COUNTY OF �7" /_u r i.P COUNTY OF DENVER
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
thisday of__ jgrV 20 Eby this'JgWay of March ,20 18 by
/,jr-j FrI4S16 Tom Saurey
(Name of n acknow dging) (Name of person acknowledging
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(Signature of Notary Public-State of Florida) l I tureof li -State o Colorado)
Personally Known OR Produced Id n ification v Who is personally known to me and did not take an oath.
Type of Identification Produced
Commission No. (Seal) Commission No. 20024 17819 STEPHATILERNOTAILIC
Notary Public State of Florida STATE OF COLORADO
A 'e Geekeihain NOTARY 1E)200-24017819
My Commission GG 248758 MY COMMISSION EXPIRES OCTOBER 11 2021
Revised 07/15 0 , Expires 08l08l2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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