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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Permit Number: rP() d ;k - 0 3�
RECEIVED
Date:
S�Vo L7l.:J��LS
o DEC 14 7010
Building Permit Application Permitting Department
5t. LyRle County
Planning and Development Services /
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: v-4,JH FL LL C
PROPOSED IM`PROUEMENT'L�OCATION
Address: "i 1 CbC'_,� = L-4 r"A 1ANiel
Property Tax ID #: 1 I • (0 13 ' Odd' Lot. No. 74-
Site Plan Name: L- CL-k-Iff-e,V 0 ► cl C� �1L �_)Y11 Block No. In (D
Project Name: I-�777P 1�L Z--Lo—
DETAILED DESCRIPTION OF.WORK:
trl �-� r �l S�ru G`i-I^ta'•l - �%1 � _ R�,�n j 1. �t l�r��
,a
1
New Electrical Meter_ySecond Electrical Meter.
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all th t apply:
_Mechanical _ s Tank —Gas Piping all
V Windo s/Doors _ Pond
�ctric Plumbing _ Sprinklers _ Generator V Roof Pitch
Total Sq. Ft of Construction: oD Q 3 3 Sq. Ft. of First Floor: I (o So
Cost of Construction: $ ) J i�� Utilities: _ Sewer Zseptic Building Height: )J(U
OWNER/LESSEE:
CONTRACTOR:
Name W 3T)-4 FL L L-C/
Name: M rx- b,)
Address: 3091 GOVtMCrS . 5)C Z
Company: W J 14 F] _ 1 L-f,
Address: 3CPo1 1 �'�ov eNCOCM t_CLK_r_ ►2 She
City: )0 tcDra 5 State: aA
Zip Code: 3 CSC) 1 Fax: yp�
City: IV —Gi^® `u-i State: Gq
Phone No. 3al
Zip Code: 300 I Fax: Mor
Phone No �I 1 a 7 G i� c� acr_
E-Mail: cor m i+:'('S
Fill in fee simple Title Holder on next page (if differen?'
cttli�i�D�
E-Mail PCP Lk-N '+ rr►t, o�nnuYh )'1
from the Owner listed above)
State or County License C&C, '74 59
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.
.SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGN ER/ENG I NEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: Mulhem&Kula
Name:
Address: -jddgrookaide Ave
Address:
City: Ambler State:— PA
City: State:
FEE SIMPLE TITLE HOLDER: N ot Appl ica bl e
BONDING COMPANY: Not Applicable
Name:
Name:
Addressi—
Address:
City:
City:
OWNER/ CONTRACTOR AFFUDVIT:Application bhereby madetonbt inapermittoJotheumrkandinstaUadnnasindicated.
| certify that nowork orinstallation has commenced prior »othe issuance ufapermit.
St. LucieCoun makes no.representailon that is grarifing,a permit will- aUthodid-th6 permit holddr to build,the subject structure
which is, ffi.cori%ct with any-appiltabl,6 Home Owners -Ass6clAtion rulq�j bylaws, ciiii,and coven'AhU that may restridt 6f Ofohlbit such
inconsideration cfthe granting ufthis requested permit,]duherebyagreethat|viU.|naUrespecb'perfo,mthework
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, '
accessary structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure tqRecord aNotice sfCommencement may result inpaying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
With |pndprnr;in nttornpo6pfnrpcnnnnoencinowork orrecord ioe:vburNotice ofCommencement.
signattpure;e�6wner�.Ve��pe/Contractor as Agent for Owner
Holder
Swo/n to (or affirmed) and subscribed before me of
SwKn to (or affirmed) and subscribed before me of
Presence or Online Notarization
Physical Presence or Online Notarization
fq ay of r,�tCAjElffl)96�'
Name of person rrl�aVf4ngs tem6nt.
Name of person mak?fig statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced.
Produced
(Signature of Notary Public- Staje_pf_FjpLjdaj,,.,,0.&
(Signature of N ar� Public- S a e
F- i
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REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
DATE
COMPLETED