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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED / L�
Date: Permit Number: �� [
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•,G'l .04 ''Y�.Kjpr.-- -. Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:i(772)462-1578
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PERMIT APPLICATION,FOR:
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Address:
Property Tax ID#: zu U d - LO Lot No�G��
Site Plan Name:.--. _ Block No.
Project Name: �C_l x-.l d 7
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New Electrical Meter Second Electrical Meter
73 K a4 = a F x S
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Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank —Gas Piping _Shutters _Windows/Doors _Pond
_Electric L—Prumbing _Sprinklers _Generator _Roof Pitch
Total Sq.Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ l�7 Utilities: —Sewer _Septic Building Height:
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Nam 1-r14 Name:ROBERT S BRUHN
Address [� / /� 'Company:L'OUDEN POOLS
City: State:�� Address-4306 S US 1,
Zip Cod ': I/ /Fax: City: FORT PIERCE State:FL
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Phone No. � �' %L /;3 sz) Zip Code: 34982 Fax: 772-465-1063
E-Mail: Phone N0772-465-2700
Fill in fee simple Title Holder on next page(if different E-Mail Pwxlisa@yahoo.com
Cfrom the Owner listed above) State or County License cpc1458612
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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.
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SU� LE ,ENT L�CONSTRUCTIONLIE�N�LAW FiORMATION. sx> rtr_ ����� pk v xe: r
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DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: '1;W OJ-- ,9— Address:
City/4 State: City: State:
Zip: s Phone ` . - v""Z1/ - - 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 exemptfrom 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 and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
_.WithJdrid&e6rbh-;Jittqfhby before commencing work or recordin our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA L STATE OF FLORIDA
COUNTY OF �_ [�� �L�—�" COUNTY OF L�
S�orn to(or affirmed)and subscribed before me of Sw to(or affirmed)and subscribed before me of
Physical Pres h?e or Online Notarizati n_ h sical Pres a or Online Notarization
thi ) day off -'.� 2071 by this day of��.__ . 202 by
� � ��C-�� f � 62RT S BRUHN
ame of person making statement. Name of person making statement.
Personally Known - OR Produced Identification Personally Known x OR Produced Identification
Typeoflldentificatio' ! Type of Identification
Priiduced� �'� Pr u ed
i Signature of Notary Public-Sta lorida i nature of�Nota public-State of rr SHERRI���c �HERRI FEHLMAPI g J� r° P) Commisalon#GG 187 611
a iaalon#GG 187160
Commission No. a�� Commission No. r� LSSeaI Expires March14,20
� m ( xiras March 14,2022 s � °P� g)eneedTtw
$p Wp [30 od ftub�9bdog NourysW= FOF EI
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
�. DATE
COMPLETED '
Rev.
. 2