HomeMy WebLinkAboutScanned from a Xerox Multifunction DeviceALC APPCICASCE 119FO IGIOa i 6E COfr[EitD FOR APPEICAA i IUM 1 O 6E KCCEP i ED
Date:
Permit Number:
Building Permit Application
rTann.ng anD aevetopment services
tr_,'M,'ng anD CoUe tteguiation uivision
[&aQ v.rg;n:a A-enue_ rort rierce_riJ4_-s2
PRone: iii,zi zF6z-i:)aa Fax: (ric) ZF5rl3rs camillei CIal Reaidential
PERMIT APPEICAI lulg FUR: Tv, ScIizLt frur" drupbex, slick arm,. at thu and of line
Aaaress: LDS La �-- � IA rJo-)\
leeal Description: La)C: R%,j Y6w:)r_ . `QaEbdd -e5k.Vf— 21 n -t gar+
-c-Al "�Pc CLS -�howrl_ in or 'ot'Gllo`'�wco_ yvex_ce (_ Los Lcx4oS
Property Tax ID #i: 3Lkx) o -A UVI - mo. -1 Lot No
Site Plan I9anmc:
Pro;ret N .rnc: S \ - Voarh \tj 11+ --
'cinr.R; Fropir 6acR: rtigRi zoine: [en sine:
010CR Ao_
DETAILED DE5CRIPTIUN OF WORK:
Keplc ,r. +�u �a 1 gra V- ILr✓+r z c- w 1 A n n la a n d rq (Oars
i•t'►n ?QV\ and v Ck\\k-
C:UNSIROLIIUN INFURIOIAIIUN:
Aaamonai worK to oe errormea unaer
ORvAC Gas janR
rnis permit– cnecK
E]Gas Piping
an appry:
_-Auxiers
winao: s70vvr;
Electric W rlumRing
LizprinRlers
Gene raw r
Roof rcoor pitch
i oral bq. Ft or Conszrucdon:
City: \P&OQ6rac_ SLaLe:V=1_
'�q. FL. or Firsi Floor:
Jp Cotle:62 -i�� rax:
Cost of Construction: 5 t Utilities: [j Sewer E]Sep is
Buildins Height:
U W IQ tK/EE55 EE:
LU I4 I KALI U R:
MameE Ll
I9ame: Zace ,' I)MI U S
Antirc. a: ':I Lbs L-accs Lxl
Cvrm,GRy:
City:QQ�Sfi Lt �r� � State: _EL-
Address: aR M US N�U�,
ZipCode: Fax:
City: \P&OQ6rac_ SLaLe:V=1_
PRone Ilio,�������}W
Jp Cotle:62 -i�� rax:
E -M .ie
PRvnC MV. f L -
Fill in fee simple Title Holder on next pare I if different
E -Mail:
from Lhe owner lis.ed above)
$Late or County License:
If value of constirurtion is $ziaa or more, a RECORDED Rotice of Commencement is require'a.
,oubm%4als@cl� A'AuG�%t cn
5U PPIMEM I A[ SUMS I RUL -1 1 19M [IEM Dew iIvFURMIA I 1—UM:
DESIGNER/ENGINEER: x Not Applicable MORTGAGE COMPANY: x " Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Ph e: Zip: Phone/
FEE SIMPLE
Name:
city:
Zip:,
OLDER: x Not Applicable
Phone:
BONDING COMPA
Rame:
Addr
City _
zip:.- A/ Phone:
I C.FTify tRat ria .0A oP in.,Lollo[ieri R_ commencea p.-ier to [Re bz"e nce yr - permit.
x Not Applicable
St. Lucie CounLx makes no represenkadon that is granong a permi, will authorize Lhepermit holder Lo build the subject structure
Wni.n :3 in eonfl;cl -itri vPit .pplic-Bic Rome V—Ars Association Laic,., 6,10 or on tri -t mFy re.trict o, e.onir"]it ;uch
structure. Please consult with your home owners stssociadon and review your deee for any restrictions wriicR may apply.
in consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the wo!k
in accoreance with tRe approveM plans, tRe Florida BuilQing Codes ano zt. Eucie County hmenaments.
I Rc rollo-ing oailtling permit applications are exempt rrom anaergoing a Tall concerrenc, re -ie .: room Azlition,,
accessor9 StrUCtllres, swimming pools, fences, walls, signs, screen rooms and accessor9 uses to another non-residential use
WARNING TO OWNER: your failure to necord a Rfotice of Commencement may result in your paying twice for
improve-Znt� tC; your property. A Notice of Commencement must be recorded and pu,ted on the aobsite
before the first inspetTion. If you intend to obtain financing, consult with lender or an attorney before
commEncin wCrk or rEcording your Notice of Commencement.
Signature of er/ Eessee/Agent i bignatare or Contra P/Eie�n.,� Ralacr
STATE OF FLORIDA
r_t3o v I T OF StU iw
I M. rorgoing L.,tra... CRT :aZ m�
this _5nL t,ay of �- e hCUGIC'V ru aby
Oennio Z_vek
(IQo,..c vt persvn oeRnO-lcagins )
(Signature of Nota y P b 'c- State of Florida j
STATE OF FLORIDA
CUORI I T OF stLove
Talc torgoin6 instra...ent was acknowledged before me
MIS Day of Y"c.�T. c'u my
Uamms Z_wk
(name or person acitno-ledging j
{]ig�oLa. r or not..—, Pub- tote et Flo. Ia. )
Personaily Rnown x OR Produced Idem f;cation Personally Known x
I yPC vt laentitic.tion PrwaarcE j type or Identiocation Pr(
A
ITH BERBY
Commission. No. Fr22vaso :i�:'' (SUmmis;ivn IQv, FF2 o970
MY CO MISSION 0 FF2209
EXPIRES April 15, M9
t�Cyt °l�-0'S.] FbrsleNo���rSe^Kc.wrr
KeVised O f 1151 LV 121
OR Produced Identification
471004MMISSION A FF220
EXPIRES Aprit 15,2019!
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COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
OHie
COMPLETE
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