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BUILDING PERMIT APPLICATION
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (� Date: SCANNED Permit Number: I i O I - O0 BY St. Lucie County Building Permit Application 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 Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPROVEMENT LOCATION: Address: Legal Description: RECEMO JAN 15 2019 permitting Department St, Lucie County Property Tax ID#: 2307 - 13 7 J 600 / - DOD — / Lot No. Site Plan Name: Block No. Project Name: Setbacks Front Back: Right Side: Left Side: DETAILED DESCRIPTION OF WORK: i ' t �" acpGGiJPcGy. �� �i'vr� 11Ps�Lilf�" (yb--� � �o»uiVri-//x/ - /i�(� Lyrna-y]b '/i>�fS /• I �y - �R .�� �/��! NG,ri �%La� SPv{0r ,oPi ✓L�r✓ / CONSTRUCTION INFORMATION: III 11HVAC Li Gas Tank 11 Electric 0 Plumbing Total Sq. Ft of Construction: i Cost of Construction: $ O-o Piping ❑ Shutters ❑ Windows/Doors nklers ElGenerator F]Roof S Ft. of First Floor: _ Utilities: 0 Sewer E]Septic Building Height: Roof pitch OWNER/LESSEE: CONTRACTOR: Name 3 9&46X Name: 7A P4, rl /yz 'ar awi�e /G Address: W A/ Aaz C,f ti. - ✓� Company: . 116 e City: ��. �crr-e Zip Code: .3q r%l)� Fax: Phone No. '7 7 a - 37o - l97 / State: Lt / Address: ro t City: /'/, / State:-il—CIC Zip Code: 3iiL/? Fax: Phone No. 77,2/-.370-5;2 7 E-Mail: G Ve-42 0%11114, Y Fill in fee simple Title Holder on nex from the Owner listed above) page (if different / COIL E-Mail: /!.a, (h'OCHv1 %D%r4. /vrn State or County License: C 6( 13 2 0Y3 7 If value of construction is $2500 or more, a RECORDED Notice of Commencement is required. Suf-WLEEMEN kL CONSTRU _ _. _ N LIl=l11 LAW INFaRMli4T - ION; I3ESIGRIER.- . __-_ - Name: e U Je e- luoi licabtg `� c ;GAtaE£9 AEt _fk A dole Name: Address: ir:o- /,address: LitX gip: P-hone 77� Stag �rs��b'��� PIT- State:. Zip Rhone: FEE SIMPLE TITLE HOLDER: Name _ Not.Appiicable BONDING£OMPANY3 __Not Applicable Address --- Zip: Fh©ne: f1WNfif/CORttiCTU_1iA_f61_DUt gppflcafionISfigFebymadgt6obfiatnapgimttiadoitre�voffcandairstallatwirasmdiwted. jcertiifyi&afj; :,i (7tIC(7tinstallation haszommencedprior to. theissuanceplapermt St. Lucle County makes no representation that i`s erantinea oeimit will authoriir ti permit Mulder to build the subieM structure ffi considerationofttie-graiitiKg: ofthls regiiesY'ed pe'imtf,.f'do-heretiyagree ttrat'fwill; in atlrespects, perform file wor& in accordance w th the approved plans; the Florida Building Codes and St- Lucie Cuuntv Amendments: The following building permit are exempt from undergoing a full concurrency reviews room additions, accessory s Ndgres swimrtimgpools fences, Walk signs; sereerr rooms and aceessoryuses to another non-residential use improvements to your property..A Notice of Commencement must be rei beforethefirst=rcrspectiorr,Ifyoamtent t olAwnfinancing;consuitwith POMm-WS_ifig o2[k Ltec4F na= vQu N4ti a 4L fner,c tietlt -- �� Lure ofOwner/ Lesontractoras.AgentfiorZ3u++er Signture f__ntrado/licenseHolder. STATEOFF-1DE-)A STR- flORIDA COUNTY OF 5+. Luc i e C OF�-__� The forgoing instrument was.acknowledged before me The forgoing instrument was acknowledged before the this off-Aday ijT on r __ _20An b[ this JW�ado of r -ZD 11 by c �ac�c� MCDAi n e Name ofptUph malangstatement *ameofpers inaliingstatemeat Personally Known OR Produced Identification Personally Krown OR Produced Identification Type of Identificativrr Type oFtdentlficatiblt Prodruced Q ( �% Produced (5ignatureofNotaryP istilw4tstteehLl jS-ignatureofNo-_-_�9iNSIprI__ Notary Public State of Flonda Q.d90�F Comiiiissit5h No. g _ Cdsti D INo- otdA Notary Public Stare d Florida Cd91i D Pasch �L30 Conitlt15510R PP ',� �p My Commisswn FF 193030 oipd' Expires 012612019 OMMM51 o, no Expires 0126/2019 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE- MANGROVE COUNTER- REVIEW REVIEW REVIEW REVIEW REVIEW" REVIEW DATE �5 RECEIVED COMPLETED Rev. 812/11 3 ' t_r