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BUILDING PERMIT APPLICATION
All APPLICABLE INFO MUST BE COMPLETeLirOR APPLICATION TO BE ACCEPTED "P Date:? / gPermit Number: ( Iy3 — V5 _. RECEIVED MAR 0 8 2018 Pefnnittin Building Permit Applications' LuceLoa rnonSCANNED Planning and Development Services BY Building and Code Regulation Division St. Lucie Count 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential PERMITTYPE: Vl b/al& PROPOSED INP OUEMENT LOCATION: .Address: J-- o ©LAFR-.JC/A#L lk4IF41' Lc� Property Tax ID i,: 31271}may' OG�- 880r1- d S� Lot No. Site Plan Name: 1 L- tj b e Block No. Project Name: DETAILfD DESCRIPTION OF WORK: 4 ftW W Ak CONSTRUCTION INFORMATION': Additional work to be performed under this permit- check all that apply: _Mechanical _ Gas Tank _ Gas Piping _ Shutters —Windows/Doors Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction: Sq. Ft. of First Floor: o_ Cost of Construction: $ 2."1 sV Utilities: _Sewer _Septic Building Height: OWNER/LESSEE: CONTRACTOR; Name: GMrL 14 /r7 0- Name 12- r Address: ��� its Q Company: rL B�� C�Sl+ Ye City: r CT f � State: i Address: - g Aors--S, /1 City: Z ,Pr. if.-ecr ; State:, Zip Code: 1A0%W - "-,'Fax: 772 - 482- S Phone No: 72 = 2 ry ^ 2 Zip Code: 3 I-q ✓rz_ Fax: E=Mail:°�C %-l , /+D 1. CAM Phone No, Z- -2 = ZS-ra'-8 Fill in fee simple Title Holder on next page ( if different E-Mail e!-Q 1 B t&- 0 A D Cal" State or County License L 8 L O from the Owner listed above) 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. SU PLEMENN II CONSTRUCTION LIEN LAW INFO MFFFF. DESIGNER/ENGINEER: of Applicable Name: MORTGAGE COMPANY: ' foi t Applicable Name: Address: Address: City: State: Zip: Phone City: State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: _ of Applicable Name: Address: - Address: City: City: Zip: Phone: Zip: Phone: OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the wo& 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 covenant3 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 p on the jobsite before the ; inspectio If y ntend,to obtain financing, corisult:with lend or attorney.before com w or r or i Notice df'Ccimmenceme • Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder STATE OF FLORIDA COUNTY OF�� c l,-e STATE OF FLORIDA A), COUNTY OFClie The forgoing instrument was �acknowledge before me i The for ping instru en w s acknowledged before me this day of 20 by this r S day of J 20 by rm,' (_ I nV [c -Cj_ n)l C-1/ I Ha_ Name of person making statement. -i::� Name of person making statement. Personally Known OR Produced Identification Personally Known OR Produced Identification Type of Ide catio Type of Identification Produced bL Produced (/^ of Notary (Signature Pu ic- State of Florida) -- (Signature of Notary Puffin- f to ida rd ELtsla 1VA UG HN Commission No. ,�Y.^ ao `-State Commission No. ,Jh"" EL EN'VAUGHN o ' °'O JJ,, �k=st !kloride-Notary • _ of Ion e=NoteryPublic Commission q Got 270079 Pub _ Corrimisalon p GG 27007 �Ac` M co """'!"O` .Qctober 22, 2022 "' tober 22, 2022 REVIEWS FR PLANS VEGETATION SEATO E COUNTER REVIEW. REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE COMPLETED Rev.