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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �)
Date: Permit Number: y P 06
S'-fir. L I U LU,�
RECEIVED
Building Permit Application OCT 01 2020
Planning and Development Services Perrnftt1q5,0epartrnent
Building and Code Regulation Division Commercial Residentiat County
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax:(772)462-1578
PERMIT APPLICATION FOR:
_— -- 1
PROPOSED IMPROVEMENT LOCATION:
Address: :"5 1 e 1 US 0 a A-Ve,_ --
Property Tax ID#: �I - � lG� - �U"� Lot No.
L
Site Plan Name: � '� -. Block No.
Project Name: —
DETAILED DESCRIPTION OF WORK:
�S 5U4k 4
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
94
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors -Pond
Electric _Plumbing _Sprinklers _Generator _ Roof Pitch I
Total Sq. Ft of Construction: �3�� Sq. Ft. of First Floor:—
Cost of Construction: $ Lj ODD Utilities: —Sewer _Septic Building Height: _
OWNER LESSEE; CONTRACTOR:. _ ---
Name,CS US CV J i Name: c�Div, Sul( (Y\
Address: � �� .r� �l� t�VZ Company: `Z � 1( l C(-0
City: D( � LI-Le(A Stater Address: 3 i)� I�1Ly rC•►'�f
Zip Code: Fax: _—_ City: Stater
Phone No. --Y)Z - L Lam _ Zip Code:-31 _ Fax: _
E-Mail: Phone No=—L- �G Jik �3i5 III
Fill in fee simple Title Holder on next page(if different E-Mail
from the Owner listed above) ' — I State or�G my License V)l , --
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
If value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required.
DE51�,NER/ENGlNEIER: iVot Appiicable MORTGAGE COMPANY: Not Applicable ,
Name. Name:
— MM'
Address: Address:
City; State:. City: Mate;
Zip:, phone Zip: Phone: '
FEE SIMPLE'T'iTLE MOLOER:— Not Applicable--- BONDING COMPANY; Not Applicable y
Name: _ Name: _
Address: Address: --
City: City:
Zip: Phone: Zip: -Phone: .__._._..._._
OWNER/CONTRACTOR AaFFiDVIT: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.Imcle 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 YO'OWNiER: YOURFAILURE TO RECORD A N OTICE OF COMMENCEMENT MAY RESULt IN YOIUIt PAYINGTWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A iilOTICE OF COMMENCEMENT MUST HE RECORDED AND
&SOS ED ON THE JOS SITE BEFORE THE FIRST iN PtECTION. lr YOU INTEND TO OBTAIN HNANCING, CONSULTWI YOUR LENDER OR AN ATTORNEY BEFOIRE RRfECO.ROING, Ufi NOTICE OF COMMENCEMENT-"
Silt6ture of Owner/Lestee/Contractor as Agent for Owner fiig�ature of Contractor/License Holder
STATE OF FLORIDA SLATE AP FLORIDA
COUNTY OF K O,rkti r) C UN TY OI- Q,a� 6 _ t
The forgoing instrument was acknowledged before me The;�rgoing instru nt was acknowledged,before me
1
this a&day of . Ft.16 20ZO by this, t�day of --C' 2OZ6 by
Name of person making statement. Name of person making statement. s
Personally.Known OR Produced Identification Personally Known M ,_.OR Produced Identification
Type of Identification Type of identification i
Produced Produced
(Signature cif Nota -ti ic-State of Florida) i (Signature.of Notary Public-State of.'. IN t% Notary PUbhC State o F
Britnt Klein
CommissionNo'� q � yr �lyotaryPubl.eStateof ld�Wn sionNo. Q t ._ :PSI}fJ+yCor»m+ss+onGG 6
Britni Klein ✓y n expires tOMTi2027
a My Comm+seson GG 26 596
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REVIEWS FRONT Z VEGETATION SEA TURTLE MANCRO'
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