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HomeMy WebLinkAboutBuilding Permit Application AFFUCARM Wo MUST so COMP10720 ram M09UCATROM To WE acc2prIED Date: 1 RECEPI. D NIAR 24 7017 App0oc Planning and Mevelopment selvices Building®cid Code Regulation Division 2300 Virginia Avenue,Fait Pierce FL M-9,92 Phone:(772)462-1552 Faso:(772)462-1578 CommereW t,"' ReMdent!M PERMIT APPUCATION FOR: TO Se ct from dropnom, CHCk alfa 9 at the and of ling, G3®P � phwdpRO�9C Mn E T L®QA�'106\90 Legal Description; Property Tisa ID*: 13 3S Lot Wo. Site Plan Name: Block AID. Project Name: Setbacks FrOM Rada: Right Side: Left Side: 77. MIO O @INOP O @ orM E er$ IS permit®C ec a� app�: UB VAC Gas Tarift ElGas Piping _Shutters 0 Windows/Doors LLMM�Electric ®Plumbing sprinklers Generator El Roof Total Sq.Ft of construction. Sq.R.of First Floor: Cost of construction:S Ic) UtilitiesSewer LJSeptic Building Height: E Name Rieavae: 116 C, Address-, 7 � Company: ,— City: e 3tate: Address: -7,9 "_. Zip Code• 9, • • Eris: City: :e rf e state: Phone No Zip Code: 3 y 9 na Fan: 7 7� E-Maik Phone No. L-1& C/ C7' E- Bili oifflpl@ 4u8i@�lo9dQrr ow P��e Q ug d°at�rew4 -Rli�il: �.'« c�-, s� fo'@m the o ^nor Booted a.oWQ state or.county UceOse:C C ( 0ff l'9due of Cons4reeaeon h sigffa @r Gii QIFGo a RIECORDED MUM©ff cMMGu"iMQc@MED2 b IFGgQ9QP®d. DESOWMVERMANER:. Not Applicable METSME COMPARM ®Not ApplicaWe Imams: Name: Address: Address: (City: State:� City: Phone: Zip: Phone: Zip: Phone: [FEE SOMPLE 4OTLE HOLI.DER'. Not Applicable SONOM CcMV P&M. —Not Applicable Meme• blame: Address: Address: City: City: Zip: Phone: Zip: Phone: certify that no work or installation has commenced prior to the issuance of a permit. St.Lucie Counmakes no representation that is granting a permit will authorize the ermit holder to build the subject structure which is In comic$with any applicable Dome Owners Association rules,bylaws or anscovenants that may restrict or prohibit such structure.Please consult with your Home Owners Association and review your dead 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 �RAG°3(r`l00`M TO �7®�e ff flubs t®RG=Fd @ H@tire ofd Commencemen UR@U V&SU02 on VOMF Paving ftfte 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,consuk with lender or an attorney before commencing,worts or recording our Notice of Commencement. e 1 S ature of Owner/Lessee/Agent SICn re of Contractor/License Holder S4(R E OF FLORODA I STATE OF FLOR006%. COO UNTV OF—, X51 /_i.,c - e- COMNTV OF SJ - /_L-C - The forgoing instrument was acknowledged before me The for oing instrument was acknowledged before me this day of �� c-� 20 L by thisM day of 11-16.r'c k .20 1`7 by (Name of person acknowledging) (Name of person acknowledging) _ Jg - - pz�')'gj A, (Signature of notary Public-St a of Florida) (Signature of Notary Public-State of Florida) Personally Known OR Produced Identification Personally Known ✓&R Produced Identification Type of Identification Pro pe of Identification Produced w,a, a Commission No. .voIWNC-iflttOlFioH mmissionf�®. a ,�N,, MARTIN • 'COgp106810!FF 216951 , .Notary�u-b71 -Stu®of FiorlN 'r M COMM.2 A S 2D1 � Commission M FF 216951 • "'w Bondad iIIfU1.Nohry Assn. a- y o Revised 0711-1 ��Y`'' Bonded through NationalNOgryAm . REVIEWS FRONT ZONING SUPERVISOR PLATS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW ®ATE PLETE INITIALS