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BUILDING PERMIT APPLICATION
All APPLICABLE INFO MUST BE COMPLeED FOR APPLICATION TO BE ACCEPTED Date: 7 ). 0 . .1 z Permit Nu SCANNED BY St. Lucie County Building Permit Ap Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial PERMIT APPLICATION FOR: erteV.c1vr/ PROPOSED INPRObEMENT LOCATION; nuw cno. s vw- Legal Description: Property Tax ID #: Site Plan Name: Project Name: Setbacks Front Back: C Right Side: Left Side: i � I JUL 18 2018 00Ding Department St. Lucie County r FL Residential Lot No. Block No. MUUIL1UIIdI WU1R LU UU PU11U1111UU UIIUeI LIIIJ pUili IIL—UIIUL-RdII uldL dpply: _Mechanical _Gas Tank I Gas Piping _Shutters —Windows/Doors ,X Electric ZC Plumbing _ Sprinklers _ Generator _ Roof Pitch Total Sq. Ft of Construction:. Sq. Ft. of First Floor: c� Cost of Construction: $ i o Utilities: —Sewer _Septic Building Height: la OWNER/LESSEE: CONTRACTOR: Name ZiMiM4Ae ,I Name a Address/OLd17 Sou oC£'h--/,D°%l0, `Company:�ll�J� So�1(10/�S ;Address%Oe_t&r'tiLlfll CF. City: �'€�SFa B�4G� Zip Code: Fax: Phone No. MS as%"y%lag State:t _ City:—Q sL State: Zip Code: 3g,75,o1 Fax: Phone No 77ol %06(oo E-Mail: Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail Cpr, C State or County License CGc s 2a If value of construction is 2500 or more, a RECORDED Notice of Commencement is required. SUPPLEMENTAL C©NSTRUCTION LIEN LAW INFORMATION: DESIGNER/ENGINEER: _ Not Applicable Name: " ; MORTGAGE COMPANY: _ Not Applicable INarrie 'c Address: Address: City: State: _ry Zip: Phone City!,, J A'? State: Zip: Phone: FEE SIMPLE TITLE HOLDER: _ Not Applicable Name: BONDING COMPANY: _Not Applicable 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 conflict with any applicable'Home'Owners.Association'iules, 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. Iri 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-'rvdsidential 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 recordine vour Notice of Commencement. r Si na re of Owner/ Lessee/Contractors e t for Owner STATE OF FLORIDA COUNTY OF 5_I I& % e— The forgoing instrument was acknowledged before me this _5Lday of-'r()no 2011by (Name of person ack(fowledging ) (Signature of Notary Public- ate of Florida ) Personally Known OR Produced Identification Type of Identification Produced ..,.I a .. ®. myr.nuuMcinmane e.e $T `—"RRES; October 27 I . - ,,.f .,.Sa! Triu Nowy Pubic Lin of Co tractor/Lic se HolderSTATE OF FLORI COUNTY OF t(�A�VMSignature The for oing instr e t as acknowledge fthis day of 20 Uyk. LLB (Name of person acknowledging) ��!!��t/✓m�� (Signature of Nota ublic- State of1. Florida ) Personally Known OR Produced Identification Type of Ide _t pigp t A, - •- r No: U • (Seal) - REVIEWS FRONT ZONING.,., SUPERVISOR PLANS VEGETATION.-, SEA -TURTLE, X'MANGROVE COUNTER REVIEW; ' 'REVIEW REVIEW REVIEW • REVIEW REVIEW DATE RECEIVED DATE COMPLETED nev. //Lu14