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All APPLICABLE INFO MUST B� COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �' a Permit Number:
" N RECEIVED
Building Permit Application JUN 02 2021
Planning and Development Services Permitting Department
v5t.Building and Code Regulation Division Commercial Residential �V Lucie County
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
Address: 5/W-1 e-Z 'Ui y ra Plca',c c Fly 3gety<1
Property Tax ID#: ZyZo lt2L Lot No.
Site Plan Name: IZ S ins Block No.
Project Name:
r o 2��LyLCyC T�isTl�d 1�dw tZvy'FwCm- Ry�� Lt- 5�.4r1� 1VQ� P�EI- � sTicX-
���
New Electrical Meter Second Electrical Meter
CO STRUgi N INFORMATION: .
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 rvt-C Pitch
Total Sq. Ft of Construction: 1 go0 Sq. Ft. of First Floor:
Cost of Construction: $ 27 00- LOWUtilities: —Sewer —Septic Building Height: s:v
WNERjLESSEE _,:.. CQNT . �,•
Name nANctif I3 . DL w i-cT Name: 5TFve1,ji �'c�srou� wks
Address: 3t3j):] Co+_-CeZ 'Kwa Company:/`�t;c��wW
City: 'V`T in e State: Address: .3L3►
Zip Code: 3 L(q f� ) Fax: City: (;jtepcc State:C__L
Phone No. -71 Z VQk F03 1 Zip Code: 3g9&a Fax:
E-Mail: Phone No '7 7 Z Z(ro Flo'-+-7
Fill in fee simple Title Holder on next page ( if different E-Mail
from the Owner listed above) State or County License L01LV<1
Le of construction is 2500 or more,a RECORDED Notice of Commencement is required.
e of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required.
PPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION.
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING 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 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. 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County an s e e jobsite before the first inspection. I )ujrj1eFrdjo obtain financing, consult
with lender n attoefey b ore commencing work or recordin o otice me ement.
i Signature of Owner/lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORID
COUNTY OF & LL)c( 'Z COUNTY OF �L L)
i
S r1on to(or affirmed) and subscribed before me of Sworn (or affirmed)and subscribed before me of
Physical Pres r Online Notarization Physical Prese c r Online Notarization
this I day of U(� 21)7-1 by this L day of L')T 21)?1 by
S(:e_u(�_uA (L - ��k Ue V, Af-S �C)4 C'
Name of person making statement. Name of person making statement.
PersonallyKnown y OR Produced Identification Personally Known / OR Produced Identification
Y
Type of Identification Ty e of entification
rod c d P oduc d
q�J"
(Signature of Notary P is at FI rj"iE PHILLIPPE (Signature of Notary Pu
Notar Public,Siate of Florida RENEE PHILLIPPE
Commission No. i GoOeW0 GG 179276 Commission No. oQa i NotarylState of Florida
My comm.expires Mar.4,2022 Com iss #GG 179276
My comm.expires Mar.4,2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev75/6/20
MICHELLE R. MILLER, CLERK OF THE CIRCUIT COURT - SAINT LUCIE COUNTY
FILE # 4871380 OR BOOK 4620 PAGE 152, Recorded 05/28/2021 02 : 32: 13 PM
- RECEIVED
4-
JUN 0 2 1011
NOTICE OF COMMENCEMENT
r Permitting Department
- Permit No. Tax Folio No. 242o 47-l QQa l�.ono l _ St.Lucie County
rr�ct State of Florida County of St_Lucie
yv The undersigned hereby gives notice that Improvement viN be made to certain real property,and in accordance with Chapter 713,Florida Statutes,
-• - the following Information is provided In this Notice of Commencement.
0 = Legal De_option of Property(and street address H available):
I - - I- i E k � -1 E i "S o� 7 sf- T+++r 3ZFr
M `TN u 3v3.Sf M1V coc-Tc�'�/ Tn— IRZ er Ta f cH c�.� O.R2 k�-7 Y
W General deswiptlon of improvement: Te ¢2v.n a .c ,� IP"6t..a cr r�i-as _n ie'_.:✓
Owner Information or Lessee Information If the Lessee contacted for the Improvement
Name T'> -t7C-w _t
(n Address
1 _ Interest In property Os�+..,r-✓z
Name and address of fee simple titleholder(if different from Ownerlisted above): .
r -
< Contractor's Name:_Cgg5-fo.v Es./\� :�,�c-yr.J 4r uC
Contractor Add Phones Number Tl2.Z\6-Ab�(7
0 f Surety(I applicable,a copy of the payment bond is attached):Amount of bond:S
T
Name and address: Phone number. _
T_ Lender Name- Phone Number_
WLenders address:
r" Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided by Section -
Mi 71a."11(a)7..Florida Statutes.
W Name- Phone Number:
Address
L.L.i In addition to himself or herself.Owner designates of to receive a copy of the -
Llonar's Notice as provided In Section 71 .13(ij(b),Florida w Statutes-
��,,��yy Phone number of person or entity designated by oner:
W Explration date of notice of commencement (tire explratlon date may not be before the completion of construction and final payment to the
Qcontractor,but will be 1 yearfrom the date of recording unless a different date is specified)
® WARNING TO OWNER:ANY PAYMENTS MADE BY TTIE OWNER AFrEn-nIE EXPIRATION OF TILE Hamm_OF COmmuNCEML-NT ARE CONSIDERED
® IMPROPER PAYMENTS UNDER CHAPTER 7"PART 1,SECTION 713.13,FLORIDA STATUTES,AND CAN RESULT IN YOUR PAYING TWICE FOR
IMPROVEMENTSTO YOUR PROPERTY.A NOTICE OF COMMENCEMENT MIDST BE RECORDED AND POSTED ON THE JOB SITE BEFORE THE FIRST
,-•�"t INSPECTION.IF YOU INTEND TO OBTAIN FINANt7NG,CoNSULT WyM YOUR LENDER OR AN ATTORNEY BEFORE COMMENCING WORK OR
W RECORDING YOUR NOTICE OF COMMENC3 MFNT_
rYt Under by of per)u I*1 declare that l have read the foregoing notice of commencement and that the farts stated therein are true to the best of
mylm edge and beDef. -
co
'""" (Signature of ner or Lessee,or wner's or Lessee's Atithorized Officer/Directnr/Partner/Manger
�.+` r(Slgnatory' tie/Offteej -
" The foregoing instrument was acknowledged before me this BRIT'CANY RILEY
- day of C}-L 2D�� MYPIRES: 4—h 01,9122
I-JO'IRE3:MRrch OI,2022
By as for
1 Na of Person - Type of authority(��officer trustee) Party on behalf of hem instrument was execvtled
l IJ Personally Tmown or produced Idemlficatlor_
,rT (STgnaItumof Nota blic-state of rich) -
< (Print,Type,or Stamp Com_missioned Name of Notary Public) Type of Identifcatl on prpdueed .
70
O
07
Di itallBi ned b The Honorable Michelle R. Miller
1HEREBYfI:NTin'TIMBY RIICL BE aATRI:HM rLWR DCUEY LVkECVRDCDORFII.O(IR 9 Y
INIEomcFnyrHrsT.LtVLAWnncLFRxow T"EcmtR mu".1ALLV RECVRDED UR i11.ER IR Date: 20L.0 .28 14:32:58 -04:00
THE OirI[EOFTWAY LIICInDA,Tl'fM RQUIREfBY IATLOtiRT. Reason: ElectronicallyCertified Copy
THIS WCI'NEtT MAI'NArti ItERALTW�5A5 RlQIIIIItD BY I,AW. Location: 201 South Idian River Dr, Fort Pierce, FL 34950
Virrr lrlTtS�rrll.il[IECLtRt.COM/HHR1TfPSE{r.RT1rV-0iTH,'IAI.RECOpRS nI\'ALR)ATE THIS W(L'}/ENr.