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LIGABLE INFO MUST BE COMPLY rzl�J FOR APPLICATION TO BE ACCEPTED
Permit Number:
SGANNED
BY, RECEIVED
St, U,xI?rk-
Building Permit Application JUL 3 0 2018
r
ing and Development Services ST, Lucie County, Permitting
ng and Code Regulation Division
Virginia Avenue, Fort Pierce FL 34982
e: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential t�
PER IT APPLICATION FOR:
PROPOSED 1MPROVEMENT'LOCATION:
Addr: ss:��l ici 1 Ci l.� y- V—\ \m(le VL. S40W
Legal ascription: 9 t- ' Pi N tiV�� 5i (�"( 5 - t-� ik 0`9 - $LV, 514 Lzi a'j CMS
Prop I�,rtyTax lD #�3z/c%? . t c "_0D$� - GCO/p Lot No: 9-1 —
Site an Name:6g0el (0qC1--t9Chzn�g 0'%��' F� Block No. 1�'
Proje'�J Name: 6J0 / MY&I �2 4FC-1 - I6 eC6 EL
Setb °I cks Front Back: Right Side: Left Side:
DE 'AILED DESCRIPTION OF WORK: a
ar jqC A I PCs A2D 1 T:50a2q QUO e- '1' I i 1 .
CO ' STRUCTION INFORMATION:
Add ional work to be performed under this permit -check all that app Y.
HVAC _ Gas Tank —Gas Piping _ Shutters _ Windows/Doors
Electric _ Plumbing _ Sprinklers _ Generator _ Roof Roof pitch
Tota Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of f Construction: $ ' 2-000 Utilities: _Sewer _Septic Building Height:
O
E , LESSEE:. ;.
CONTRACTOR:',;
Name
ALL�XueA a=
Name:
-I ss: 5.4.:D (YVAQLr
Company:
Add'
city
Address:
lV oarii "`� � State:C
Zip
I
0de:?I Fax:
City: State: "
Pho
le No �i� 2 �%0 `�o?
Zip Code: Fax:
E-
� il:
Phone No.
fee simple Title Holder on next page ( if different
Fill i�ii
E-Mail:
fro
i the Owner listed above)
State or County License:
If valbe of construction is $2500 or more, a RECORDED Notice of Commencement is required.
5U
IpLEMENTAL CONSTRUCT16ITClEN
LAW INFORMATION:
DESIGNERANGINEER:
Na I
Addle
titv,
Zip: I
_ Not Applicable
•
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
ss•
State:
I Phone
FEE '
Nan,
Addl
city;
Zip: j
IMPLE TITLE HOLDER: _ Not Applicable
BONDING COMPANY: Not Applicable
Name:
Address:
city:
Bess:
1 Phone:
Zip: Phone:
.R/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
r that no work or installation has commenced prior to the issuance of a permit.
St. Luc County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which I in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
strucit'i e. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In cons deration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in acc dance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The fo lowing building permit applications are exempt from undergoing a full concurrency review: room additions,
access Pry structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WAR ING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
impr' ements to your property. A Notice of Commencement must be recorded and posted on the jobsite
befo the first inspection. If you intend to obtain financing, consult with lender or an attorney before
ni, rv. nnrine lAtt%ke nr rnre%Minv vnm it hintira of rnmmPnrPmPnt_
I
i
Sign' wner/ Lessee/Contract Agent for Owner
Signature of Contractor/License Holder
STA E OF FLORIDA
STATE OF FLORIDA
CO NTY OF 5+ 1-1A c
COUNTY OF
The �rgoing instru nt was acknowledged before me
The forgoing instrument was acknowledged before me
this day of `b 20�by
this day of . 2C_ by
Narne of person making statement /
Name of person making statement
rs Penally Known OR Produced Identification V
Personally Known OR Produced Identification
Typ' of Identification
Type of Identification
Prod cedes L L
'I
191t J
Produced
(Sig
i ature of Notary Public- Sta
(Signature of Notary Public- State of Florida )
Coin
211 'o VP� SANDRARCITKISKE
I fission No. r=:sl1ry Public •State
mmission No. (Seal)
of Flori
Commission k GG 214567
a
My Comm. Expires Jun 30, 20
2
RE!
IEWS
FRONT ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DA
RECEIVED
DA
3
F-1
aO
CO
PLETED
Rev.