HomeMy WebLinkAboutBuilding Permit Application ALLAPPUCABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date- 01711 t� Permit Number. t nn
�U
RECEIVED
Building Permit Application OCT 0 2 2018
Planning and Development SerWces
&Wdm- andCodeR 5T. Lucie County, Permit
9 egufatfon Division
23W WgfntoAvenue,Fort Pierre FL 34982 �
Phone:(m)4621553 Fax:(772)4621578 Commercial
Residential
PERMIT APPUCATION FOR: To Sept from dropbox,dick arrow at the end of tine 1 d�r
OSED�:IMPROVEMENT_LQCAT[ON ::Address: n: V
PropertyTaxl ._� �,l�D�' {�t V���"' (�" Lot No_; /0
Site Plan Name: I—G�`1% Block No.
=Project Name:
l "
Setbacks Front Back Right Side:: Left Side.
DETAILED DESCRIPTION OF WORK:
CONSTRUCTION INFQRMAfiiON•
mono wo to (�e rm un er is perm — a apP .
HVAC Gas Tank []Gas Piping, Shutters O windows/Doors
QEb ctdc Plumbing [JSpriniers. 06eneraWr O
Total Sq.Ft of Construction: . .Ft.of First Floor.
Cost of Construction:$ Zr? Ll ' Utii-rtiesU Sewer OSeptic Building H ftht:
UWNEk/LESSEE Ri.
Name { !x s�t�?��p Name: rA
Address: b 7 to3 1�u���P�G� Company: KIPLC,
v} �etrCC� 1 State:TA_ 'Address.- � fie?
Zip Code- Fax; N! A City: t"�` t -E'r State___
Phone No. �2," Z''a 0 Zip Code:i3 W S)- x Fax:
E-Maik ! Ipt Phone No.
�_ Fill in fee simple Tide Holder on next page{if different E-Mail: ce 961
from the Owner listed above) State or CountRicenw.
If value of construcdan is$2SOO or more,a REWRDED Notice of is required.
DESIGN NEER: Not Applicable MORTGAGE COMPAINY: Not Applicable
Name: Name:
Addrrles: Address:
City. State: City: State:
Trp: Phone: 27p: Phone:
FEE SIMPLE TnU HOLDER:• ' Not Applicable 'BONDING COMPANY: Not Applicable
Name: - Name:
Address` Address: '
City: 034-1 -
Zip: Phone: Zip: Phww
1 cw*thatnowork or howiiatlon has cammumd priortothe hmu ce of a permit
St Lude rr�toes na rep onthat isgrantinga fire h to bul3d thesub xswewre
wlddr LS t with �t appC�Home OwnersA�sa���or an�rNirwe rare`pay restrkt or proEnbit suci�
strucdue.Piease consulrt�uthyour Home Owners Asa#on and n�viewyour deed r arty whh spay apply.
In co Wdwa&m of the granting of this requested permit;I do hereby asgree that i wK in all rewec%pwform the work
in accordarmwa Oe approved plans,the Flodda Su kft Cadesand SL LudeCounWAmendmentL
The fdbwingbtivft pwmft applications are own"from undwpft a fuD conmmmy review:room addltiom
accessory a ruchwes,swimming pwL%fencm walls,sW*,wreew row%=d accessary uses to another non-residential use
WAUi311Ul TO OWNER:Your fWWm to ReeaM o matim of C+ommenoement may result In Yaw�varft twice for
im rovementsto your prgperty.A Notice of Commencement must be recorded andoosted on the jobsite
b�the first h pecdon.if you Intend to obtain with lender or an attomey before
comm work or Mr_dlnjt your Notice of Cornmenc eMe
Siria4rre of Owtwl Agent/Lessee S natwne of Crurkw earsMU., Holder-
STATE OF FLORIDA STATE OF FLXMDA- -
COUNTYOF , COUNTYOF
Thht�fang inln�ept war adatu�wi�� aae :Afdaygadof
enc ���adam""ds� 'n'e#,, l�yof - hT 2° by . -
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(Signature of Notary#Wft-State of Flarlda) (Sw inure,of Notary Publk State of Acarida)
Fersonaity ICU-~ OR Produced Ideruifrcdn v' Parsonallyt Kwrm� OR tMaduoM dernlllron `"�
Typeof hlamcation Produced o t. Type of I&w i=tlm Produc�i
C�ommixsion uo. � PPYpii t/
Cornrrfrs�siort No. ""°""`�°—='�'� �'__S ra'r`e R���'"�
`,.pan "—'iCAREid S. NiEl.Si*N =• of Florid EN
; ' B �state of Florida-Notary'Pu"blic Orr Comm' a-Nota`
'y �,o�°�` my Commission on''"n11„`` .y June 92 ion !xpi 484
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INIi31At5 - .