HomeMy WebLinkAboutBuilding Permit Application From:Lynn Rinehart Fax:(772)621-5959 To: Fax.: (772)462-1578 Page 2 of 5 0712112017 9:14 AM
ALLA1iFutAEtr;:.it, F0 U5T.BE'C0K4PLE3E.€7 FOR APPLiCATIdN T O-BE ACCEPT D
Date:---------------
Perrrli.Naoiliar:: 1��-d y 3
z RECEIVED JU
Building er It A pllcatlo
Planning andDeveloprrient Services •
i ulidi7-4,and Code Regulatioj.i Divislop
2340 Virgin
ia Ar en:ta;Fort Plerse FL'34982
Phone:(711:2)462-1553 Fax;(772)462-1578° CommercialPERMIT APPLICATION FOR
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Site P{anLot
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Project Name;:
Setbacks Front Hack': Right Side:--- Le
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�rrteci iii Qr : is irerrt�it—r cc a, apis y: _
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uasTank Gels Piping. Shutters ( . r—
W3ndo�trs,I ROO.s
�E€emsr.ic Pimbing 5prinkiers ierstor '• Rodf
id#ai Sq-Ft of Construction: 5. . Ft.of First E{nor
Cost of Cotistruet'ian:$ .-'%�;' :...`_J: U;ilj�i�s; S2vter u
` SePtic 8 gilding,.,eight:
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Fill erg fee 3impleTit{e Holder arr next/page(If-di p o11,Y1
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f€ rer�ti IVieril: 6' 1,Y1C_ l r
from the Owner listed abov,q) � State or county License;. '"
ifvalu,$of Cmnstru'ttion is$2500 or mere.,a REC 7RE® o;^Cyo;n�ien�cei a f is refit I �.
From:Lynn Rinehart Fax:(772)621-5859 To: Fax: (772)462.1578. Page 3 of 5 0712112617 9:14 AM
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l fiSB l E4fi� iiS ii EERt _ _blot Applicable . . MORTGAGE COMPANY, _ ._ Not Applicable
barrier, _ _
Nome:
Address: l Address:
City, State; City: Mate::
Zip: Phone: � � dip; Phone'. ..
FEE Silk PLE TITLE HOLDER- �Not Applicable BONDING COMPANY: _,„lVmt Applitable.
Address: Address:
City,. ( City:
ZIP; Phone:-zip.: {inane:
€cert€�ti a�na wor€c or instailac€nn has ca�rninenGed p*iar a ttte€ssuance.of a�ierrnEt.
St.'Lucle C60)' makes no.rep rese ntatl an that Is granting a:perit'h
rri€t ZRrlll authorize thegef rr� o€der to Wild the subject structure
lnrhj6, Is In conflict with any applicable Home D wners Assonation rules,bylaws or an covenants-that may restrict or prohi,bresuch
!4
strtrcture.Piease consultti3 your Rome Owners Assadation and re; iew your deed for anyrestrictions Which rrsay appiy.
;n consideration af'the granang.cf this requested perrrsii,t dti herby agree that l wiii,In all respects p.$rform the wnrk
in accordance 1.-.kh the approved plans, he Florida Building Codes arid.St,Lucie Cour+ty Amendments.
T"ne foilowvin'g building frerrn€t apnlic-at€ars are exempt frost undergoing a full concurrency review:room additions,
accessorystructures,swirnming penis,irides;walls,signs,screen rooms,and accessory uses to another non-resir.`e;ittal use
WARNING TO Olt NER:Ydur fa%lura to RecoM a Notice of Commencement risme ieWlif ins�okir Paying tvaite far
improvements to your property,A Notice sof Commencernerlit must be ecorded and posted on the jobsite
befIore first ins rec�ion....if you irlterid to obtain.firranci€�g,consul : r4 : n attorney before
c® encs r; or-recor -sur Notice of Cornrn.ancern
S€griatu of e v�rierlLessee/Agent . Sgnaku?'s ofi+Mont: or/..License Holder =
STATE OF FLORMA �X STATE OF;4COU INTY LCRR
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e f r iitstrGtriE?fit rs acl�i6wied ed before, s Tho fp%oI'pg instru„rr�sn�eras acknovriedged before m �,.
tale '$sly of `� t � � _ � 20 �y gE? ��� � €iris:rr�s flay of� . .2s1 �by
`-Ac I l' : ffi'i4 arr,;�
(dame f parson acknowyled €ng) (:Marne cif on adknowledgifzg.}
. �tatttcpr
�20
(Signature of Notary Public-State of Rorida) { ignature of. , tart'Publicr State of Florida),
Personaliv known l!rl Clic,Pl ad'uced identlficat'ior - Personally.-Known �l!'�OR Produced Identification
Type of€gI'entificat€on Produted Type oflden0cation Produced. _
Corrsmission No. `' ( (Seal) Commisston No.., � 1 (Seal)
Rased��/.t5{2U1�
AEViEWS ' FRONT l WNW SUPERVISOR i PLANS V C-7s TAT1ON SEA TURTLE MANGROVE
CC3U kITER. R£V.iEW: REV.IE `J ! REVIEW . REiftEW R_ViEW RE'VBTI
DATEs
COMPLETE s
INITIALS € i.