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BUILDING PERMIT APPLICATION
i All APPLICABLE INFO MUST BE Cr Plvgr LETE OR APPLICATION TO BE ACCEP 1tu II Date: ��' �f ' �O Permit Number: f 264 - 3'8 '4i 'Buis d' r�i 'rVbrmit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 X Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMIT APPLICATION FOR: Address: 9,1100 Le al Description: LOT LAT (:3 o K r arc 13mje- e.T., bS ' MONf G 10A-6C 5 Pit 2 c46 , ,�'L 3 q ,-ARLo Co UNTRd C_IUis ,5/ U nr rT' O N£ Property Tax ID #: I Lot No. I Site Plan Name: i Block No. Project Name: L-L l 7— C� Setbacks Front Back: Right Side: Left Side: DETAILED DESCR'IPTION,OFWORK:, kemoDe- rl Is,Sr2 o5A-rfJ F A W cid cr Zcl. c C= GR.ESS S N-0a,- VL f—% d k Cr0 o w l 'Fe 13c- AFC ff&6 /o' l e 7-0 13 4 A&ct , PlED Ajo 6.Y I-ZAo2 06&,C ACCP,a , PZ,t R. K k- COFNSTRUCTION INF9R11tIATION � t {t Additions work to be pertormed under this permit— check all that app y: - _Mechanical _ Gas Tank'. _ Gas Piping _ Shutters '� Windows/Doors Electric Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: 2 I S Sq. Ft. of First Floor: 3 7 1 Cost of Construction: $ 4 t5,bo o Utilities: —Sewer —Septic Building Height: PWNNER/LESSEE: - CONTRACTOR: Name AM�ES Rid Uk� �11E� .. Name: Address: 9 q60 tiVE MfZK C T Company: Address: City:%, PI« State:%L 3q,15! Zip Code: Fax: City: State: Phone No. l�o �$ `I'S �' G zip Code: Fax: E-Mail:_ elf ev- So e*"! Phone No Fill in fee simple Title Holder on next page ( if different E-Mail from the Owner listed above) State or County License If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. St1PPLEMENl'A�CQNSTRUCTtfl►N LI N;LAW I1VF©RMATI4N �. 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 Home conflict -with any applicable Owners Association rules; bylaws or and coven ants•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 your paying twice for improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite before the first inspection. If you intend to obtain financing, consult with lender or an'attorney before commencing work or recording our Notice of Commencement. C Signs ure of Owne Lessee/Contractor as Agent.,for Owner Signature of Contractor/License Holder . STAT F FLORIDA ,.. OF'C STATE OF FLORIDA . COUNTY J COUNTY OF The forgoing instr wcknowledged before me this � day of 204-7 by The forgoing instrument was acknowledged before me this day of 20_ by (Name Vf person acknowledging) (Name of person acknowledging) (Sig ure of Notary Public- Stat9 of Florida) (Signature of Notary Public- State of Florida ) Personally Known OR Produced Identification�`� Personally Known OR Produced Identification Type of Identification Type of Identification Produced Produced . ,a"wr% L '"NA INGRAM Commission No. .,,,��"_. `y° Seal Sate of Florida ( ) Commission No. Seal (Seal) :nres Dec 20, 2018 11 REVIEWS FRONT ZONING . .• . , ;h Notional Not1t1 -•SUP_E , PLANS VEGETATION SEA TURTLE . MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED ev. 7/2014