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ALL APPt.[CASI.E INFO NIM BE CoEiAPlI`[ED FOR APP=MN TO BE ACCEffM /fo
` Date: Permit Number: f
p • f
3ullding Perl, ' Applicati n MA`s
Flannmgandt�velopmentSSet�sces D partment
permitting e t , FL
Building and Code Reguiotioa Division +.Lucie �(��1 n
2M Vir+ginivAvenue,Fmt,Pkrce FL 34982
Phone.(772}4521553 Fax:(772)462-1578 Commercial
I-FPE�R�m�rFAIPPLICAMN FOR: To Select from dropbox, dick afrow at the end of line
PROPOSED NPROVEMENT I CCAMN.
Address: �0 Q u,-t-I-M \ Port St.Lucie 34952
'Legal Ue ptiun:part of 3444-5014709-tFs3 M-Spanish Lakes One
Property Tax ID#; Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back:_Right Side. Left Side:
L ETAILED DESCRIPTION OF WORK:
Demobion of mobile home
CONSTRUCTION INEORIMATIQN:
((��Itsona wo .c to 17,
orrme under t is perrnrt-check a t appy:
.,}HVAC Gas Tank E]Gas P"tping _Shutters F]Windows/Doors
Electric U Plumbing [3SPrinkiers O Generator O Roof
TotalSq..Ft of Construction: Sa.Ft..of First Floor:
Cost of Construction:S Utilities Sewer[J Septic Building Height;
Qin` NERA ESSEE: 'RACTOR:
Name np- l CoqpoName: Matthew Lyle Vlynne
Address•8000 South US 9,Suite.402Company:� Deeielopr Corporation
Pott St.Lucie Stater_ - Address:8t3M South US 3,Suite 402
ZIP Code- 34952 Fax:7?2-878-0224may_Port SL Luse S FIL
Phone Itio.772-878 513 Zip Code: 52 P=.T/2-878-0'224
E-Maihs Yqnrxebc-corn Phone No. 772-878-5593
in tee simple Tore Homes aft next page(V different E-fillaii:st yrmebc,cxom
from the:tuner listed.above} State or County license: GUC.ff3599.9
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
ms`s+
SUPPLEMIFENT-AL CONSTRUCTION LIEN LAW INFORMA-110M
DESIGl EgIE>NGINEER: tot Applicable MORTGAGE COMPANY: NotApplicable
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: Tip: Phone: "
I certify that no work or installation has commenced prior to the issuance of a permit
St Lucie Caar��ty►makes no representation that.is granting a perm will authorize the p it holder to build the subject structure
whlch is in.cos►flict with any applicable Horne Owners Assouation rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult vhffi your Haute 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
I in accordance with the approved pians,the Rodda Building Codes and St,Lucie County Amendments
'The following building•per n it applications are exempt from undergoing a full concuuen ey review:room d'itions,
accessory structures,swimming pools,fences,walls,signs,,.screen rooms and accessory uses to another n derrtial use
WARNING TO OVVAIER:Your failure to Record a Notice-of may result in paying ate for
improvements to your property.A-Not' a of Commencement must be recorded and sled on the jobsite
before life first inspectiorkdring
you int d to obtain financing consult rcvith len or attorney before
cornrxiencF. work or Nabce of Commencement
_Signature.of Agent Srgnatu r/license Holder• ;
STATE OF FLORIDA STATE OF FLORIDA
COUNTYOF sirup COUNTY OF stwde
The forgoing instrument was adcrmMedged before me Theforgoing"instrument was acknowledged�b/efore nae
ay
t#ti tL-dof ��a , 2t} Y this" .r day of_ _,20 1
.moi.by
(Name of perso owledgging) � :(Name flf dmowledging)
ignature�of Notary Public-state ofpo . ) 6in`a re of Notary Public-State of Flo" � E
Personally Known x OR Produced ldenditcadon Personally Known x OR Produced Identification
Type.of Iden ilitation"Produced Type of Identification Produced
commission No. .i�Y P�'.•. Sl��r��f�! � Comas �;�---- �, a1}
181647 � &U AN MAA
EXPIRES:Febrijary?_3,2D19 �.pg�^v6%,
=^: ? My C0kjMISSI4N#FF 187647
EXPIR S; a t(at
Revised 07115 Qcnded 1'Iw Ngtary FubGc Unden+�kers -
i REVIEW FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITiAtS