HomeMy WebLinkAboutBuilding Permit Application AL APPLICABLE INFO.MUST BE'COMPMED FOR APPLICATION Td.Bir ACCEPTFp
Date;_ I_. 1.�. Permit Number:
MVED
Pull'ding Permit'Appli atiop MAY 11 2011
Planning and Developrrient,Services
Rui!ding and Code Reg010tioh DiVjSidn
2300 Virginia Avenue, Fort Prerce FL 34982 ��
Phone: (772) 462-1553 Fsx. (772)X162-1,578 Commerciale Residential
PERMIT'APPLICATlQN F.OR,� To Select Opp dropbPX, cllck-Wow at the end of line
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Address:
Legal Description: '
Property..Tax ID 4 — 2"U4'9 -'LL C�( 2�''L�UD
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Site Plar�`Name': �C Block No.
Prolect'Name: M_AA.' D K'
Setbacks Front Back- Right Side: Left.Side:
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HVAC Gas Tank oGas Piping Shutters indows[Doors.
Electric Plumbing SpnnJ<lers '. Generator. Roof
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Total sq: Ft of Construction:* . ��: SQ..Ft. of First Floor;
Cost of Construction: $`1;a1T ' r9_ �_ Utilities: Sewer.l I Septic Building Height: . 20
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Name IV Oa'i S [ Name: S '.. �.. Cl
Address:. I. D Company: CGt 1
CitY Pi, ( 2/ State: Address: 0 .1 S. tit
Zip.code: �a � Fax: city:.... D.!`�'�-� . J .
Stater
Phare i�fa, Zip Code:`
E-Mail:_. Phone-Na, .-7'7.x. .
Fill Ih fee sirriple TitIQ Molder on next page (If different k-Mail: �i
from the Owner listed -alcove). State or County License:_�(( (.Q? �
if value of construetipn is $2500 or more,a RECORDED NotLe r5f Commencement is required=
=e.
SU-PPLEMENTAL CONSTRUCTION LIEN'L,AV1/ INFbRMATION:._
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: 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 thepermit 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 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
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 recording our Notice of Commencement.
s
g `tur f •ner/Li=ssee/A`:_mt ature of Contractor/ cens of er
STATE OF FLORIDA STATE OF FLORID
COUNTY OF ;y�. • I/l,{, (,(�(J COUNTY OF _ _ -� (X4 CCtJ
The forgoing instrument was acknowledged before me The fo
rgoing instrument was acknowledged before me
this Q�ay of 20 1) by thisq day of___M.CvA 20 _19by
pos4m:.
(Name of person acknowledging) (Name of person acknowledging)
I ra l'-/d
( i nature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known `� OR Produced Identification
Type of Identification Produced 0 232 -S" -SS�f?3- Type of identificatioonn�Produrc-ed/- -�/�
Commission No.f f 9 (Seal) Commission No. r r 9(o o�l�'J (Seal)
Q4Jennr Davis ;Q Jennifer Davis
Revised 07/15/ ` ife
My Commission FF 966029 y�, v My Commission FF 966029
Q4• or Expires 02/20/2020 cls Expires 02129/2020
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW,;
DATE
COMPLETE
INITIALS
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