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Building Permit Application
,►PPLICABLE INFO MUST BE COMPLETED FOR APPLICATION'TO BE ACCEPTED -Date: a,n l S Permit Number: )156-t-6355 'RECEIVED AUG'24-M Building Permit Application Planning and Development Services Building snd Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982.. V/ Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: \A L Address: z &1�2pk sd.0 & Legal Description: Property Tax I[3 Lot No. Site Plan Name: Black No. Project Name: -- Setbacks Front Back: Right Side: _ Left Side: /0 ff16 110 wor to be pe rme under this permt—check all that appy: _Mechanical _Gas Tank _Gas Piping Shutters _Windows/Boors Electric Plumbing _Sprinklers _Generator Roof Total Sq. Ft of Construction: Sq. Ft. of First Floor: Cast'of Construction:$ JD Utilities: —Sewer —Septic Building Height: Name lelm 97* AyIaLl-I -- _ - 'Name: Curtts Salmygorl � — -- Address: � _.. ait.e. -. Company: Cus��; A r 5+4sim, = — City: / {i /�_-- State: p� Address: { 1 S S `U r {( � -oa- r rt 17r Zip Cade: /� © Fax: _ ri City: �o�-r T L1tC i State: FL. Phone No_ aLL NIL Lf,;Lf,;/Lr� ' _ zip Cade: Z4q,%` Fax: qz iaJj,l�(R_ E-Mail: -- -- Phone No. `I7 335 -3Q?_ —_-- -- Fill in fee simple Title Holder on next page(if different E-Mail: Cu Sfict tir Su '0601'Cl CIA Pram the Owner listed above) State or County License: C-A Co 5 is l0 . s4a�e - If value of construction is 2500ror more,a RECORDED Notice of Commencement is required. ��7D ��■r�Iw:��i r riZ r ■ate 1 �.�+—.�.��� i �■■ 111 I�i��.uu�r�.�i i a1 rr.+�� DI IGNER ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable Narne: Name: Address: Address: lv"atyr State: City, . State: Zip;, Phone: Zip; ;, Phond: FE0iMP1IE Tt7tE HOLDER: Not Applicable B ROIN43 CDMPAW-. _,Not Applicable Name•, Name: Address: Address City: City: Zip: Phone: Zip: Phone:• OWNER/CONTRAaOR 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.Lucre County makes no representation that is granting a permit will authorize the permit holder to build the subject structure 1' which is In conflict with an applicable Horne Owners Assactation rules,brylaws or and covenants;that may restrict or prohibit such structure.Please consult wyith your Home Owners Association and review your Beed 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 pians,the Florida Build�pg Godes 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 failtire to Retold a Notice of Commencement may result In your paying twee for Irovements 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%0ith lender or an attorney before commencing,work or recordi ng your Notice of Commencement.OJ�— Signature of owner/Agent/Lessee Signature of Contractor/License Holder STATE OF FLORIDA STAT`OF FLORIDA COUNTY OFS T I.•V C 1'e COUNTY OF• 671- LU C t e The forgoing instrument was a owiedged before me The forgoing instrument was�acknowledged before me this s;+ day of Wa4a.51_. .2�� by Lhis , ,day of�f1S* ZO .by f urfls �+�►nrrlcrn� �'+�r�s �_�€r�r»d� �, (Name of person acknowledging ng (Name of person acknowledging) � u' . a ' (Signature of Notary Public-StatW Florida) (Signature of Notary Public-State of rids} Personally Known ,OR Produced Identification Personally Known '� OR Produced Identification Type of Identification Produced__ .11W m eau Type of identification Produced ��_"A� 7" WCOWWHEW� Commission No. i<1 a� v *�I EXPIRES.Apse 4,9017 Commission No. �'�d°arQ�loa 4 � POW Gfsmel � °�� ba,daaTMo6�dp�tNde7 EXPRiEg:Apte�,zDf REVIEWS FRONT ZONING, SUPERVISOR PLANS VEGETATION SEA TURTtE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE RECEIVED DATE; COMPLETED _F I ev. 7/2014