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Home My WebLink AboutBuilding Permit Application Date: 1 S Permit Number: , 5 RECEI','7D NOV 122015 Building Permit Application Planning and Development Services Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce Pl.34.982 Phone:(772)462-1553 Fax: (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line a .,P , .. .:,..,v.:l 7t,.,,,....,>t.S:.SI...t.,..: a..... t:.{.•,.; ,. 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(� City: State: T--(— 'Address: &W%1-\ vi Zip Code:_3 qG !-t j_ Fax: 8 0,,,1= City: \Q= --- State:TL Phone No. 1.1A g2 l 30 _ Zip Code: 3 %i ` Fax: E-Mail: Phone No.=7_�2� t-k\\ T-7 [1 Fill in fee simple Title Holder on next page(if different E-Mail: l a from the Owner listed above) State or County License: Ifi value of construction is$2500 or more,a RECORDED Notice of Commencement is required. 01 A # ZZLH9t LL BL96Z9ti of :W0JJ, 9ti 90 5�-OL-LL 11-10-15;05;45 ;From: To:4621578 ;7724618722 # 2/ 10 s., afc�e,.r•: ^,•n^r.� •%).c '.SS�';• S i�;4•ki?�3;i=i-^•3.4? S.�!. nt,.l.:.�v?.1:,5.i.�.my-l.4y�:%`,�� .v4„'1':ti�ti•">+��• .. .. :':: :. r •. :. ;:. ..::'. 4 �.r" : - 5n�.5if}7i:fsr..::/�,i.�_.ry1y. .:.�t'.�'::Y:'��:Y_•F1G�5Y5ry _l.f::':>3"i::>}. :rN•i=oR•.tvtAY�aN'.:-:� ...:......:..r. -.:y.�*�',,�;;_ ;...,. :.,:.,.. DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable Name: Name: Address: _ _ Address: City: Stater City: State: Zip; Phone: _ Zip: Phone: FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable Name: Name:_„ Address: Address• City: -- City: Zip: Phone: Zip: Phone: 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 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 1 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 noxi-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 record!nR vour Notice of Commencement. s r-1-nature of owner/Lessee/Agent gnature of Contractor License Holder STATE OF FLORIDA ' / „' STATE OF FLORIDA COUNTY OF / COUNTY OF The forgoing instrum nt��}�"�as-a-qknowledged before me The forgoing instrum nt was acknowledged before me this��day Of O r'/Ga�YI�� 20 aby this L0 ay of 6111 M 20 I5 by (Name of person acknowledging) (Name of person acknowledging) a; (Si ature of Notary Public-State of Florida) gnature of Notary Public-State of Florida) t-- - Personally Known C.��OR Produced Identification- Personally Known OR Produced Identification Type of Identification Produced Type of identification Produced Commission No. Commission No. RA HOHMANN A HOHMANN a�nNr^v"�, ,'..'•_ Notary FUbllC-State of Florida }�. *' Notary Public-State of Florida y 1680 �< Commission sS'on II FF 671b80 ed 07 15/20 �k Commission#FF 07 .,,R„fro?,.` 1teVx$ u` ,` Bonded Through N3llonalNOtdlyAssn �nrnn�� Bonded Through NationalNotuyAssr6 REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE tnu rtat c