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Building Permit Application
All APPLICCABLE,II�NFO,MLIST BE COMPLETED FOR APPLICATION TO -BE ACCEPTED Date: CJ I " � Permit Number: Z ()0'5- ' 0 YOU ''- RECEIVED ,. AUG 2 4 2020 Building Permit Application Permitting Department, — Planning and Development Services St. Lucie County Building and Code Regulation Division Commercial Residential. 2300 Virginia Avenue, Fort Pierce FL 34982 _1 Phone: (772) 462-1553 Fax: (772) 462-1578 PERMIT APPLICATION FOR: Address: Property Tax ID #: 2©� - CGS ..�(�Ci �� _ Lot No. Site Plan Name: Block No. Project Name: � J New electrical Meter Second Electrical Meter Additional work to be performed under this permit- check all that apply: _Mechanical _ Gas Tank — Gas Piping _ Shutters _ Windows/Doors Pond _ Electric _plumbing _ Sprinklers Total Sq. Ft of Construction: Cost of Construction: $ ZUOD. 6 O Name GIP�I"_ S _ Generator _ Roof Pitch Sq. Ft. of First Floor: Utilities: _Sewer _Septic Building Height: Address: 3 3 rE a. City: - e� Stater Zip Code: 3K4 y-J Fax: Phone No. E-Mail: Fill in fee simple Title Holder on next page ( if different from -the Owner listed above) Name:S " G Company:'�,�� Address: City:_ 5-�- Lec esB Stater Zip Code:. 131-10IJ-3 Fax: Phone No 770- E-Mail- K45�) P<&- V (v G/L_� 1. (Pj•v, . State or County License 2 q 259 f value of rnncfrnrt;nn v')cnn .. — - ---- -.... .., ...-&, .a — a.vunnencemCni Is requires. If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required. v DESIGNER,[IENG�INR:� .____`Not Applicable Name: Address: 1 I't (off'- J f s ,E4 e City: /« State: VZ Zip: 33 �P = a Phone S� Zt�aE i.90 FEE SIMPLE TITLE HOLDER: '_Z of Applicable Name: -- Address: city: s one- MORTGAGE COMPANY: of Applicable Name: Address: City: State Zip: Phone: BONDING COMPANY: I"otApplicable Name: Address: City: Zip: _Phone: }..x,, a x OWNER/;CONTRACTOR AFF•IDVIT: 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 prier to the issuance of a permitp St. Lucie County makes no representation that is granting a permit will authorize r and covenants that may estricutbor p ect structure'ih which is: in conflict with any,applicable Home Owners Association rules, y structure. Please consult with .ybur Home Owners`Association and review yourdeed for any restrictions which mayapply: 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 WARNINGTO.OWNER: Your failure to. Recor&a Notice of Commencement;mayresult m paymg,twice for. rnorovements.to'your•property: A Notice of Commencement 'must"be:�recorded in the;public;records..of. St... Lucie County and posted' onthe jobsite: before -the first'inspection. If yoU intend:to obtain financing, consult with lender -or an attorneybefore commencingwork or recording our Notice of Commencement. Signature of Owner/ Lessee/Contractor as Agent for Owner STATE OF FLORIDA COUNTY:OF ' Sworn to (or affirmed) and subscribedbefore me of Physical Presence or Online Notarization this day of , 20,_ by Signature of Contractor/License Holder . STATE OF FLORIDA COUNTY OF Sworn to (or affirmed) and subscribed before me of Physical Presence or Online Notarization this day of , 20_ by Name of person making statement. I Name' of person making statement. Personally Known OR Produced Identification Type of Identification Produced (Signature of Notary Public- State of Florida Personally Known OR Produced'Identification Type of Identification Produced (Signature of Notary Public- State of Florida ) Sealmission No. Commission No. (.Seat) REVIEWS TA FRONT ZONING W VREVIEWON ' S REVIEW LE 'REVIEW VE COUNTER REVIEW REVIEW"E IVED COMPLETED All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED' Date: S` �r%� Permit Number: Building Permit Appli Planning and'DevelopmentServices Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial -PERMITTYPE: PftCOPt+OSED lMP 01lE � T LOCATI MAY 2 0 2020 Ca pon- ermitting :L"C' artment St. Lucie c0i , t �e FL Residential Address: `S--S l.$` ©rot'13 e/- OWe to t Property Tax ID #: 2 � to 0 5 — 060/ —W 0— Y Lot No. Lila Site Plan.Name: t��oG �(,l% 1 (7�2 � Block No. Project Name: Additional work to be performed under this permit —check all that apply: _Mechanical _ Gas Tank' _ Gas Piping _ Shutters Electric _ Plumbing Total Sq. Ft of Construction: yS 0 Cost of Construction: $ Sprinklers _ Generator Sq. Ft. of First Floor: Utilities: Sewer _ Septic Windows/Doors _ Roof Pitch Building Height: C?WNER/LESSEE: GfJNTRMIT O Name m Nae: A & �/ ,L % h Address:G,.%-- Company: City: -Farj� AA -A ` : :.-. :=_State: Address:.:.3V3.z.. City: S Stater Zip Code: �Pq Fax: Phone No. - ' Zip Code': E-Mail: Phone No = 3 �7L 3-9 E-Mail /�A Zt 6 �� G •Cow Fill in fee simple Title Holder on next page ( if different from the Owner listed above) State or County License Z Zs9 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. E - •S' DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: Name. C3e--nor- So�S Name: Address: +9-i6& t s,P oV�`l, Address: City: 'Tu State: F-e— City: Zip: 3'3 ` w Phone Zip: Phone: FEE SIMPLE TITLE HOLDER: —LAot Applicable Name: Address: City: Zip: Phone: f-Ti7k17pretail] 0,1]_10ys Name:_ Address: City:_ Zip: Phone: Not Applicable Applicable 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 OF 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 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." /RC� Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA Jj �� ' I STATE OF FLORIDA ) COUNTY OF �S4 h 1/�(il COUNTY OF /•-LLB C 1p— The forgoing instrument was acknowledgeJ before me The forgoing instrument was acknowledge before me this �ay of 20Qby this—.7-0day of73_C[q 20-by Name of person making statement. Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Identification j 6 ? Type of Identification Produced f - 1 L Produced (Signature of Not P ic- State o Florida) (Signature of Nota ublic- State of Florida ) Commission r..pd^AiinREyB.FIUfSII�IiEY Commis R,�{ypP� niiOg}{UMPHRE Seal *, MY COMMISSION # GG 300817 .,,. MY COMMISSION # GG 300817 m: Q.Inv no n9Q I. REVIEWS '%F9F Ft°Q Bonded ru Notary Public Und rxriters VISOR PLANS "' "a'FOFd�4 ThfU o PublicU a ito ANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW. REVIEW DATE RECEIVED DATE COMPLETED Rev. 2/7/ 19 4 x 7