HomeMy WebLinkAboutBuilding Permit Application ALL APPI,ICAPLE INFO MU5T R COMP-LAT-91D FOR APPLICATION TO Of ACC9FT11)
Date! 2017 Pqrmlt Number:
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T! Planning and Detifflopment service�
JAN 3 1 2017
iand Cpda Regulation Division
ff Virginia Avenue,F0d
Phone;(772)462-1553. Fax:(772)462-1578 Commercial RegiOntial X
PFR I APPLICATION FOR' To Select.from dropbox, aliqk
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Legpl N' • 1 INDIAN RIVER , 17-BLK27 LOT 30
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NamQ.ANI` "-$ Name..JAMFSDEIPATINA
Addrew e1' SEAGRAPEr~ Company: c L
Address,
Zip
••' •° PORT ST LUCIE St-Ate-FL
Phone NO. 2�ip Code. 34986772-878-5144
Phone No.
simpleFill in fee • page r. r) G r •
if " . 0L n a 091 r r' y ,
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DESIGNER/ENGINEER: _WoAp icable MORTGAGE COMPANY; Not Applicable
Name: Name:
Address: ,Address:
City: St�t : City: State
Zip: Rhone: Zip �.I .., Phone: . . .
FEE SIMPLE TITLE I10l.DR: Y Not AppilCabl PO�I[�llE'+�1� pMPAIVY: Nat Applicable
Name., Name:
Address: Address:
City: Clty:
Zip: Phgne: Zip: _P146ne: .. .
I certify that no work or installation has commenced prior to the issuanep of a permit.
St.I.t�Gie Coun,%makes no representation that is granting a armit will authorize the permit holder to build the�uhject structure
which is In conflict with any applicable Hood Own rs Assoc stion rules,bylaws or and covenants thpt may restrict or prohibit such
structure,Please consult with your Home Owners eAssgcjatian and reyia w your daed 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$t.Lucle County Amendments,
The following bullding 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 angther non-residential use
WARNING TO OWNER:Your failure tq Record a Notice of Commencement may result in your paying twice fqr
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,consuit with lender or an attorney before
commencing work or recording our Notice of Commencement.
.• Signature of Owner/Lessee/Agent Sfgnature ctor Lice Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF UTLUCIE CPJUNTY OF srLucre
The forging instrument was acknowledged before me The forg ing instrument was acknowledged before me
this day Qf 20 Eby thisi-day of-,J 20 by
JAMP pFGATINA JAMR6 gEGATINA
(Name of parson acknowledging) (Na Q pf person acknowledging J
Ignature of Notary Public-State o I da) (Nignature of Mptary Public-State& loriaia j
Personally Known x OR Produced identlfieation Personally• d tif' a 'o
Type of Ide „• Type Of Ide If�r ,oduced ,
�
`� v°�A�'s 6ENA l.4AENZ RUF �*� byUrIVA LUKtNi KUF '`• . •
.4 . c Notary�'y -blic Sta
commissio - Notar Public-Stit O)ROda commissio !
Commiselon#FF'9679s7
txldres Fib 7462' ;,, �� MY Comm.Expires Faso 7;4626.
P 10.1,10Revised- 15/XY? WAIF
REVIEWS FRONT ZQNINEi SUPERVISOR PLANS . V9G,i TATION SEA TURTLE MANGRQVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
_ffATE
COMPLETE
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