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All APPLICABLE INFO MUST BE x: IAPLETED FOR APPLICATION TO BEACCEP`rrb ^ 1
�°� Date: �j• �Z • Z ( J)ro �FV SAAit Number: S 9
:: RECEIVED
a �
Building Permit Application MAY i 2 2021
Planning and Development Services
Building and Code Regulation Division F3rSt. Luc Department
Si. Lucie untY
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential- L_
PERMIT TYPE: Sim LeiL1
Address: I'90ni rLO- 42�L_ 3yJ45-
PropertyTax ID #: 29jo -- L/11- 000Z -- 0007 Lot No.
Site Plan Name: L•eon)4 ,Pr R's,"cQeatA Block No.
Project Name: Leo nmrDT Resc��
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Additional work to be performed under this permit — check all that apply:
V.-Mechanical ' _ Gas Tank 4 ' _ Gas'Piping _ Shutters
(Electric t, Plumbing _Sprinklers
Total Sq. Ft of Construction: a )A5
_ Generator
Sq. Ft. of First Floor: 11,9 a
,-'Windows/Doors
Roof V�j2 Pitgh
Cost of Construction: $ 232,,51q Utilities: —Sewer —Septic Building Height:
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35 r.�rY41?4�i
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Name 9dw. n Leon fkcdT
Name: mr,-
e_t1_ 717 -Fr�lAL Gt�
Address: B95 (4S6y Lan:
Company:
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City: F-r 1�0_ rL.'L State: 0—
Zip Code: 311 °! b 5-- Fax: '`_(W
Phone No. 502 qa5 6"77 3
Address:!2'3
City:
Zip,Code:
Phbne-No 1
State:�L—
3LIgLi =. Fax: 772 S°6S- "7873
--r7X- -77gI
E-Mail: Talknin tn
Pren
Fill in fee simple Title Ho eo n toa6l (if di
from the Owner listed above)
-Mail d r' rnv1 Cy),!s4z, v7t L+ eoti✓►
State or County License 1?i31goo 36a
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:r _Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: — Not Applicable
Name:
Address: .
City:
Zip: Phone:
MORTGAGE COMPANY:
Name:
Address;
City:
Zip: Phone:
Not Applicable
State:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVI : Application is hereby made to 0
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
structure. Pleasecconsult with your Home owners AssociationAssociation
tiand review your deed for any restrthat
ct o s which may atrict orl. prohibit such
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 JOB SITE BEFORE THE FIRST INSPECTION_ IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/ essee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF L
The fo oing instrument was acknowledged before me
this day of
l�N 200�� by
6tO L
Name o person making statement.
Personally Known OR Produced Identification
Type of Identification
(Signature of Notary Pubic- Stafe of Florida
Signature of Contra ctof/Kense Holder
STATE OF FLORIDA
COUNTY OF e
The fo oing instrument was acknowledged before me
this day of 2qRL by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
gnature of Notary Public- State of Florida )
%%%M/, �.� BEN S. NIELSEN mmission No.
Commission No. ,o pY°bBo%state o Florida -Notary Pu li
=. ►_ Commission # GG 2074 4
oFF�O.�� une 12, 2022
REVIEWS FRONT
°"` ANS VEGETATION
COUNTER REVIEW REVIEW REVIEW. REVIEW
DATE
RECEIVED
DATE
COMPLETED
tev.
(Seal)
SEATURTLE I MANGROVE
REVIEW REVIEW