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BUILDING PERMIT APPLICATION
All APPLICABLE INFO MUST BE CON, _ -_TED FOR APPLICATION TO BE ACCEPTEC., Q Date, - .I /� • ��� Permit Number: �U� � • `r � Building Permit Appli RECEI1.VED n NOV I32018 Planning) and Development Services Permitting Department Building and Code Regulation Division pa rtment 2300 Virginia Avenue, Fort Pierce FL 34982 St. Lucie County. FL Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Resl en la PERM IT APPLICATION FOR: �A[vM�e.►.�r� CL�vt-ovrsz a� ��o���� ti�or"�, I Address: S3 C- A N\ Legal Description: SEL-a.7 TowrJ 36S' /iry6 yo£ off- ST . Li= CZ\ VFs - AND W 01i; an,g Property Tax ID #: SGANN D Lot No. Site Plan Name: BY Block No. Project Name: Cie GOLinty Setbacks l Front Back: Right Side: Left Side: • . Gas Tank _ Gas Piping _ Shutters Windows/Doors Electric _ Plumbing _ Sprinklers _ Generator 7� Roof Total Sq. Ft of Construction: i VA Sq. Ft. of First Floor: Cost of Construction- $ Utilities: —Sewer _Septic Building Height: k C' Name Cx4RO-t-ES. MAR-°'rl Address:-S;3 C-A�txAr�r ©R i_CZ(© City: o�-r S'T. Lvct-E State: FZ- Zip Code:1'3LAZI Sa Fax: Phone No. E-Mail: �11,Jai- Fill in fee simple Title Holder on next page`( if different from the Owner listed above) Name,:-.b Company.: MS =X�3_L- Add ress: 9 %A \ S W 64 H` S-r- City: Pan^pA,vo fjc- - State: Vz-L. Zip Code: 31 oC6c-, Fax:S-C-LA Phone No E-Mail 'MA<L.-1 furor) QA!:) RMS o,' F-fl . Co A State or County License CAL f value of Co1istruction iS 2500 or mnrP_ a RFMRnFn Nntira of rnmmanramant is ranidrari DESIGNER/ENGINEER: _.....- Not Applicable .Name:.:, 4. :Address:`3'3oa';�Iit 'Amo K''Tf722 ¢aLI `City: -Pc r4C&Z-"- State: r-L___ Zip: .�,Phone 9SLI - Cis,6_) .c3 FEE SIMPLE TITLE .HOLDER: ,:q 11 Not Applicable f_ Name`:``W`INrJ'�`43.y1,Ll�,rti-b �ocL-P Address:ems'=vs'�+v s-r Lvva City: ev-- - Zip::I--cSsa. Phone: MORTGAGE COMPANY: > Not Applicable Name: Address: City: Stater Zip: Phone: BONDING COMPANY: X Not Applicable Name: Address: City: Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtaiq a permit to do the work and installation al indicated. I certify that no work or installation has commenced prior to the issuance of a permit. j 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 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 decor -dine vour Notice of Commencement. 11 Si'" na " r _' ` Hrner A e I- Lesstrac o[ �S1 of Contract' r'/,License Hol er � STATE OF FLORID STATE OF FLORI A COUNTY OF COUNTY OF '3tz0 The forgoing instrument was acknowledged before me The for oing instrument was. acknowledged before me Wday 20 `S by this �b day of ocer-,-a Fj , 201`d, by this of cX-'roG•r-YL , (Name of person acknowledging) (Name of person acknowledging) i (Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida ) Personally Known o< . OR Produced Identification Personally Known OR Produced Identification Type of Identification Type of Identification Produced "AY P�4 ALAN MILLER Produced t Ay P"Q •ALAN!MILLER % c MY COMMISSION # FF 195499 Commission Nd 1�15`\wig * o (Sed];PIRES: May 5, 2019 MY COMMISSION # FF 195499 Commission NoN-\95��1 *r PJSePbIRES May 5, 2019 OF F1.�P\ Bonded,Thru Budget Notary Services grFOF F�oa�O Bonded Thru Budget Notary Services REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION ' SEA TURTLE I MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev. 7/2014