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Building Permit Application
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED //�� "� Date: 3 �Q 262_ 0 Permit Number: AV Q� J 0 l 3 I ` ° RECEIVED Building Permit Applicati Dn MAR 2 7 2020 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 PERMITTYPE: � h PROPOSED I ENTLOCATION': ,/ Address: 276:2 - aussA , Alin uk v, JJ 3Y Property Tax ID#: ZC7�S --701 '6/( `7 `3 Lot-No. -7 Site Plan Name: oy7,00 1 Block No. Project Name: / DETAILED ©BORA NOTION WORK: ( s l zt)s I el 9 I Or CONSTRUCTION INFORMATION: 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: Cost of Construction:$ /00 D- _� Utilities: —Sewer —Septic Building Height: OWNER/LESSEE: CONTRACTOR: Name: '7�, ddress: '�'•'"1(/. •w- J1� �'� Company: 4ityir:F?` }TU 'lif�i•F-�•- --- it/r. State: EZi`p Code 3 9r t'ax City; a' State: <i �• P'hc3ne No. `7� : = Zip Code, E-Mail: )G3 QX 4ai y400 w! •.;Phone No a:7 1 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. If value of HVAC is$7,500 or more,a RECORDED Notice of Commencement is required. DESIGNER/ENGINEER:- _Not Applicable MORTGAGE COMPANY: Not lApplicable Name: Name: Address: Address: City: State: City: State: Zip: Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable BONbING 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.th.e 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 Associ.ation•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 willi�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'hon-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,JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR"AN ATTORNEY BEFORE RECORDING YOUR NOTI F COMMENCEMENT:" Signature'of Owner/Lessee/Contractor as Ag nt for Owner S' n fare of Contractor/License Holder STATE OF FLORIDA STATE OF FLORIDA- C�7 LUC. t� COUNTY OF T'� LA 10 Le COUNTY OF c�� The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me this day of �(Y\Q(-k( 2090 by this,-;t Y day of (VA Q,C'Sln c--I 20'o\,()by Name of person making statement. Name of pers64-making statement. Personally Known \,Z / OR Produced Identification Personally Known ✓ . OR Produced Identification Type of Identification Type of Identification Produced Produced (Signature of Notary Public-State of Florida) (Signature o i� '' �'v offFon �•; Notary u�is-State of Florida C mmi ion GG 057931 Commission No. „ mmission No. %�J P a� �.�Par pie, 9 RLY D.MARSHALL %���� ��`,{y1 Com ,.94iies Jan 8,2021 __ =i°. .`<'•, Notary Public•State of Flori a. = ''•�°;;��•`� .Bonded!hra gn'Jat onzl Wiry Assn. rn REVIEWS FROIV ''�'.,'f r I dei mSJ , Z 21 NS VEGETATION SEA TURTLE. MANGROVE COUNT " ' !h ou•7 ss VIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. ZI 19 J.