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ACE APPEICABLE IlgFi_ MIU31 6E i-iiIPIt-EETED FUR APrEJtX1 lila 1 V BE ACCEP i ED
Date:
Permit Number:
Building Permi-E Application
Pionning ons ueveropment services
auiruing ons Cove xegurotion Division
&ZO virginio Avenue, Tort Tierce rz.j4yS-
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Phone: („�j �.0�-�3�� Fax: („z)z+6c-�j7a Commercial - — Rewdential
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PERMIT APPLIirR I ION FUK: To Select from dropbox, click arlu.,, at the end of line
Iq 1c,
PROPOSED IMPROVEMENT LOCATION:
A00ress: �=n Al 1if g �P$m 14ukhoT►sm
86d 5iq949
Legal Description: orerLri Jjca6w ou+h A
:t M O.nd and
t ntcr'eAt
PropeFty �a�lo J4a Qj'L�i'3'QOD*�
Lot No.
bite Plan Rame:
Block No.
Projeci Mame:
betnaclts Front 6aci. nigRt viae:
lett gine:
DE IAIIED DEbC:KIP I IUM OF wuKR:
`Rcptaei- AIG ext�e#- Z�f a��e U t
+R a -Mn 11f S ft -r -
s R1nl
AIC
l.uN5 I ROL I IuIQ IIaFORMA I lulu:
A00monal work to be nertormed under t ispermit - c ec
❑FIVAC 0Gas E:]
a appy:
Q
ianR Gas Piping
_ Autters Wi :av-;TD7
ar3
❑ FleCtric ❑ PlumBing ❑.)prinRiers
❑ Generator ❑ Roor
Root pitcR
i oral :)q. Ft of Construction:
z . Ft. or First Floor:
Cost of Constraction: b to ,vm co Utilities:
U Sewer ❑ Septic Building Height:
uvvMER/EE55EE:
Cull I KAC-1 uR:
Name
Mame: .,
-
IIll y�
Anaress: LA_aSO N A1� -W- W7 a
comp. my. 5
Qr
City: 50r) Warta State: t'[:
Address:
Zip Code: 3',A9 yG Fax:
Chy:
31.ate:_J�
Phone Mo. - CY 0-535
clp Cotle:.�2aCi(&0 Fax(_JjzPY/ - �
E -Mail:
PRO. -.c IQo. CI ")Zs -
Fill in fee simple Title Holder on next page ( if different
E -Mail: . '
from .he Owner lis.ed above)
SLaLe or Coun y Eicense: C140 Qt49r1,5-3
If value of constru«ion is $zuM; or more, a RECURVED Route of commencement' is required.
N/
SUPPLEMENTAL CONSTRUCTION LIED LAW INFORMATION:
DESIGNER/ENGINEER: x Not Applicable
Name:
Address:
City: State:
Zip: Phone:
MORTGAGE COMPANY: x Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE bhviPEE I I t EE nOuDER: x Mot Applicable 613MI31 G C.OMPARIT: x Mot AppliCaMle
Name: Name:
Address: j Address:
1 Clic: City:
Lip: Pnone: I Lip: PRone:
i I
I certify that no work or installation has commenced prior Lo Lhe issuance of a permit.
St. racie Coant maRes no representation tiidi Is granting a permit will auiMorize tfle ermlt Molper to OuilM the su�ect stracts c
which is in conflict with any applicable home Owners Rssociation rules, bylaws or and covenants LhaL may reSLricL or prohibit such
structure. Pleas c.m3alt MO your Horn. Ur.ncr, A..vclatian aria rc.ia r roar acrd to. ten, rc,trlctivn, which Tar apply.
In .on3iaeratioa of Ou gra111iir15 er this rcyac.tvD permit, I Do Rere5, abree that I will, in all respects, peRo.m tllc -erR
in accordance with the approved plans, the Flor;da Buildi..g Codes and St. Ca.ic Cam -Ay Arricnlmeats.
he following building permit applications are exempt from undergoing a full concurrency review: room additions,
accC3,0r'yr 3trEct5Pc,, 3.iTRlirig F0013, T..—.ce3, .+all.., jgaz, �crcepi rowrig—pit! occesso. , ase: to c.notl■icr rion'rerlDe..tlol oz.e
WARNING TO OWNER: Your failure to Record F. Noticc or Con7rncncernei-.t trio, rc.ait in your paying t -;-.ice Tor
improvements Lo your property. A Notice of Commencement muSL be recorded and posted on the jobsiLe
before the first inspection. If yuu intEnd to obtain financinr,, consult with lender or an attorney before
commencing worn or recortlinl~ your Notice of Commencement.
5ignaturc or O, cr/ Cc,3cc/Agent
a t A i E OF FEUR113A
COUNTY OF 3; eaov
i ne forgoing instrument was acknowledggd,before me
this day of E&j2 i D,
4l__ d., 5
Sijp---11-1
ature of Contra r/License Holder
a i A i E Or KORIDA
COUNTY OF ..leu..
i Me rorgoing instrument was acRnowletiged Def ore me
tri:, X aur of ash zu AY- 5,
Dennis ZacaR ean..o -MN
(Name of person acknowledging } (Name of person acknowledging }
azure of Motary r ic- state oT Florisa }
(&A a bs�
(Signature of Notarq Public- §Ate of Florida }
PC;3aR.11, Known x OR Prv8-�-.ce8 18entitieotiva Personally Known ^ i-511 ProEuce5 Men riiicaLion
i ype of leentincation Protlucea I Type of Identification Produced
Commission Ivo. re«us3 -;��' . - NEW A DERBY Commission Ivo. FF220930 : �' ; : (SMTH A DERBY
'= MY COMM15SIOR 0 FF40930 " MY COVAR055ION p FFzz
Revised 07/15/201J.'A47''ry"0 " rw.W-.rjC—
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
C00111IER
REvicvv
REvIEvv
REvlEvv
REVltvv
REVIEvv
REvitvv
DATE
Col01P[ETE
INITIALS
Sitc nma,eap
!acct la.
—meant a'
111ap.v
Sse,—ype
Zanm r,
('LIT. Coter.7
ownership
. Nmna . -.C=h Z.. T. -
2w shot Paiat or
,4luqu—u F1, 9315
Legal Description
CRrrcnr +alnea
Jm ...—kcr .Ise:
,.ss"s�d V_tee:
Tax" f0: Ihc_ rgmvl: SLC—ss rotlwun 4trKc 19
Docntoad TRIhI for this patccl: Ouwntwd POFD
Michelle RranRlin, CPA — 3ainl Lucie Zounty Property Appraiser — All rights resep*ed
Property Identification
O4M
S+tn: Lush Counsr
11.'6,91X1
11'6 900
$3
S 176 9O?
Total Areas
Finisfic—n—ir nir (Sp}
vtvss .,rra (Sr l:
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This information is believed to be catAnl at this tim- but Itis seh;.et t. -hane .-.d h not ,_wentrd
C C.p shi 2018 Sa'.nt Lwic County Proprr,—Appmisrr. All