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PermitALL APPIKABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date., 00
Number-
BuildingPermit • •fication
Planning and Developri7ent
Building r Code Regula6on
!I Vlr6inld
Phone;
• • Commercial Residential
PERMIT
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Description*
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Site Plan Name:
Setbacks81i5ck No.
Project Name:
Right Side: Left Side.
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■ Roof, Roof pitch
Total Sq.Ft . . Floor:of First
- ■ ptic Cost. BuildingSe
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Name Name-
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.. ♦ t- ny: �
Address-
Zip • :►
Code:
Zip Code: _
'S-
Fill in fee simple Title-Hilolder 4n;ln"ext page(if different E-Mail: bk
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from - Owner listedabove) State Or • License: OLAS r
constructionIf value of tl RECORDED Notice of Commencement is required.
.07/07/2033 05:47 #1787 P. 002/002
TRP
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not'Appficable
Name: ; Name:
Address: Address: ._— —
City: State: I —�--
Zip: Phone: j city, _State•
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable I BONDING COMPANY: —Not Applicable
Name:
{Address Name:. 1 Address:
Cry' City:
Zip: Phorie: Zip: Phone:'—
I certify that no work or installation has commenced prior to the issuance of a permit.
5t.Lucie Coun 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 t will,in all respects,perform the wxk
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 payujg-twice for
improvements to your property.A Notice of Commencement must be recorded and posted 012 the jobsite
before the first inspectto . If you ' tend to obtain financing,consult with lender or an alto before
Comm work or re rdin ur Notice of Commencement.
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I ure of er/L /Contractor as Agent for 0wner ature of Contra or a Holder
i STATE OF FLQWA t STATE OF FLORIDA
COUNTY OF COUNTY OF
t The f�going instrument as acknowledged before me The for ping instr ment was acknowledged j!b�efcr•e me
t this ay of 20 by ( this day of 20 .LV b
2h� 11% p dr,
P6 11'a ]Ja lt 12 '
"reowledging) �'� (Name ofperson acknowtedginu Ic-State of Florida} ur t P c-State of Florida)
1 Personally Known OR Pr°quced Identification Personally Known OR Produced identifii.atiorF
Type of identification Produced i— Lr L Type of identification Produced _
Commission No- Commission No
J SICAI10FfWW «.t _ JESS1CAtI0FFieW
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=g `4 EvkwAgqust 13 2024 _ `Q E resAugt>at
Revised 07/15/20 mod .Bouded?fruTroyfamrmtaaacaflOP3esrMs g ThrotlayFain 8U�38� s
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
i COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW j
DATE
COMPLETE
INITIALS