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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12#/2018 Permit Number:
mmimmm" SCANNED
11zW BY RECEIVED
St. Lucie County DEC 0 7 2018
Building Permit Application
ST. Lucie County, Permittin
Residential - I
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-15S3 Fax: (772) 462-1578 Commercial X
I PERMIT APPLICATION FOR: Alteration I
__9r__ _TP
Address: &9G0-8tlrhTK1_ng vd, For _1e1`CT7rr--'IlM6
Legal Description: SEE ATTACHED
Property Tax ID#: 1430-131-0001-000-4
Site Plan Name:
Project Name: Shaffi Hanger
Setbacks Front Back:
bEtAILEDDESCRIPTION OF WORK:
Right Side: Left Side:
Lot No.
Block No.
Reconfigure interior office spaces per demo/floor plan - Cun in 3 new exterior impact rated windows
to match exist'g windows - Cut in new exterior impact rated door - Relocate esist'g elect recept &
lighting per new power & reflected ceiling lighting plan - No revisions to exist'g mech or plumbing svc
1: CONSTRUCTION INFORMATION: � - I
AUUMUndl WUFK 10 Ue eF1(JFlTle0 UnUeF 11115 PeFMII — CFleCK dll apply:
z M GasTank E]Gas , - InShutters ZWindows/Doors
ZElectric 1:1 Plumbing []Sprinklers 1:1 Generator 1:1 Roof Roof pitch
Total Sq. Ft of Construction: 14.620 Sc Ft of First Floor: 14,620
Cost of Construction: $ 58,000 — Utilities. 2 Sewer D Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name FLYTEME AVIATION - BENJAMIN SHARFI
Name: Todd White
Address: 3601 SE OCEAN BLVD, SUITE 002
Company: Independent Construction of the Treasure Coast
City: STUART State: FL
Zip Code: 34996 Fax:
Phone No. 219-215-3981
Address: 708 SE Parkway Drive
City: Stuart State - FL
Zip Code: 34996 Fax:
Phone No. 772-219-6933
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: independentconstruction96@gmaii.com
State or County License: CGCO58694
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTALCONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
Name: GranfieldArChilects;
Not Applicable
MORTGAGE COMPANY:
Name:
Not Applicable
Address: 1603 NE Jensen Beach BW
Address:
City: Jensen Beach
Zip: 34957 Phone
State: FL
City:
Zip: _ Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable
BONDING COMPANY:
Name:
—NotApplicable
Add reSS: 708 SE Parkway Drive
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.LucleCount makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conrlict 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 or recording your Notice of Commencement.
SigRature of Contractor/License Holder
Signature<6f-8WffETTLessee/Contractor as Agent for owner
STATE OF FLORIDA
COUNTY
STATE OF FL
OF Mar+�n
COUNTY OFO"A.'+;
The forgoing instrument was acknowledged before me
The ing instrument was acknowledged before me
form
this&-4'"dayof DZLe,�ll 20 18' by
this 6- day of DeLe4,-&R� 26 by
-Tojok Wk,+e-
Nan't6 of per�o�naklng statement
Name of personmaking statement
Personally Known _ OR Produced Identification
Personally Known L,� OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
NM ZENIC 4WW OT FORM
(Signature of Notary Pubr4; WiNN F1 Kirkpatrick
(Signature of Notary Public ta orido* Publict State of Florida
My Comission GG 167840
Commission No. EXq5M1?J1312021
Ernifle K Kirkpatrick
ommission NO. 7XI ission GG 187B40
E
2J1312021
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COMPLETED
Rev. 8/2/17