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ALL APPLICABLE INFO MUST BE Cc,,.,?LETED FOR APPLICATION TO BE ACCEPTED
Date: 47 z7l� 1-7 Permit Number:
_.a RECEIVE®
0101g,mm- MINN
Building Permit Application MAY 2 2011
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line (�
PROPOSED IMPROVEMENT,LOCATION
Address: 30 Aqua Ra Drive Jensen Beach, Florida 34957
Legal Description: Block A, Lot 3 , Unit Two , Windmill Village by the Sea
Property Tax ID#: 4511-811-0004-000/9 Lot No.3
Site Plan Name: Storage Enclosure Block No. A
Project Name: Storage Area
Setbacks Front 25 Back: 15 Right Side: 7.5 Left Side: 0
_ WORK
DETAILED DESCRIPTION O'F
CONSTRUCTION-INFORMATION:_
Additionalworktobenerformedunder this permit-check all appy:
HVAC Gas Tank []Gas Piping _Shutters ✓�Windows/Doors
Electric ❑ Plumbing Sprinklers F—]Generatdr 11 Roof Roof pitch
Total Sq. Ft of Construction: 432 S . Ft.of First Floor: 432
Cost of Construction:$ 10000.00 Utilities: LV]Sewer E:]Septic Building Height:
.OWNER/LESSEE CONTRACTOR,
Name Arlene Lowery Name: OWNER BUILDER
Address:30 Aqua Ra Drive Company:
City: Jensen Beach State:Fl= Address:
Zip Code: 34957 Fax: City: State:
Phone No.561-755-1045 Zip Code: Fax:
E-Mail:mamaloweryQa bellsouth.net Phone No.
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.
SUPPLEMENTAL CONSTRUCTION 11EN'`LAVV INFORMATION
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: 0AG 4Q?le /tiM, Name:
Address:/,�967 W4) . 0 ,,fe_ Address:
City: G+ e_- •-6 State: City: I V I A State:
Zip:_ z Phone:8��-4�a-2�y'd Zip: hon
FEE SIMPLE TIT E HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: ,e Name:
Address: 3n Address:
City: O e ! City:
Zip: ,54q.67 Phone: !- 7• - -leZip: Phone:
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.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 Commencement.
&A,'�'A'f"/ 41f/ s
Signature-of_Owner/Lessee/Cont ctor as Agent for Signature of Contractor/Lic nse Holder
j)6 1*I•••
STATE OF FLORIDA �° STATE OF FLORIDA
COUNTYOF COUNTY OF
The forgging instr ent was acknowledged beforeX�D The forgoing instrument was acknowledged before me
this day of 1m 201 Y 2�` o this day of 20 by
c
(Name of person acknowledging) ERL s (Name of person acknowledging)
(Signature of Nota ublic-State of Florida V (Signature of Notary Public-State of Florida)
Personally Known OR- rod ced Identificati n "� Personally Known OR Produced Identification
Type of Identification Produce `(e Type of Identification Produced
Commission No. (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