HomeMy WebLinkAboutvanALL hpffl'CAMS ONFU MUST ON COM O M FOR APPUCAITSOM TO ME ACCEPTED
Date., -
4
planning and DevelOPM609 Se VICes
Building and CO& ROPOUINIOn DlmN019
23M Viminia Avenue, Fort Pi-wL- FE,,94982)
MO= P72) 4622, -ISM Fan: VY2) 462 -ISM
PERM97 APPUCA ION FOR.. TO "Sct frOM dMOOKo Oft ogre at ths WW W Uns
Address: \ 0 C3
LWI Description:
C X)0 - C,�00 – Lot No.
Site mien € ame- BIocl: Cho.
Sethaefts ROIIIL� each: �Rj& SIde.- . Left Side:
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CONSTRUCTION WORMAMRo
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ClEINVIC 0Pluffibins
Piping
115humm
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[]Sprinklers
c9enerator
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TOW Ri- Ft of construction:
S . FB. of First Floor:
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Cost of conAr Bcdam $ -
Utilities: Sewer Oseptic
rsuolding Height:
OWNERAESSEE;
CONTRACTOR:
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Cbmpany� �
Address: '7f5—
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Phone No
Zip Cede:
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phone No. L
SO in ft@ 00mp0e MO@ Holder an neat Pw g of diffemnt
E-mail: C-) c':'e
from ft ClurtgP W%W a )
State or County Li nae.
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U M LAW W0RrVY—f a UM:
Name:
Address: Mate:
City:
Zip: Phone:
FEE SOMPLE 7ME HOLIDIER, Not Applicable
Name:
Address:
EVrgORJ-GaGE cEb�pwG^ai`ri�7o
— Not Applkg hle
imari lel _
Address, Mate:
Zip: Fes®. hone:
11 owooma COMaAM Not Applicable
Name: — —
Address:
C.Ity: —. City:
Zip: Phone: Zip: Phone: ---
I certify that no work or Installation has commenced prior to the Issuance of a permit.
5t. Lucie County makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which Is In conflict with anyl applicable Home Owners Association rules, bylaws or an c a enants that may restrict or prohibit such
structure. Please consult w th your Home Owners Association and review your deed r 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 hilum w nec@rrd @ Notice @f r<flnV rrGsuOt in Vauw payorng twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobs(te
before the first inspection. If you intend to obtain financing, consc.It with lGnderr or an attorney before
commendrie work or recdrdine vour Notice of Commencement.
ignature of Owner/ Lessee/Agent
STWME OF EFLO26DA
COMG�W OIC =. -..(
Thergoing instrument was • cknowledged before me
this Sl day of -- � 20 L2hy
n�
(Name of person acknowledging)
(Signature of Notary Public State of Florida )
Personally Known OR Produced Identification
Type of identification Produced
Commission No. `11, „', (seal jj MIKE MARTIN
14 - - Notary Prr C - $tate of F110
• CorsiMsaion t FF 218451
Revised 07/15/20
NeiliewilawyAssn.
-_--�_%--' s
Signa ure of Contractor License Holder
STAYE OF FLORIDA
coo URM, O�
The forgoing instru ent we acl nowledged before me
this —Lday of 20 1-? by
(name of person acknowledging)
(Signature of Notary Public State of Florida )
Personally Known L --'"--OR Produced Identification
Type of Identification Produced
No. as...Y (Seal) MIKE MARTIN
► Notary Puetic - state of
• .CorMnieeion # FF 21
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
StATURTlrt
MOM
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATECOUNTER
COMPLETE
INITIALS