HomeMy WebLinkAboutBuilding Permit ApplicatiomALL APPUICIABUE INFCI MUSH BE CICIMPLET9D FOR AIPPLICIA7ICIN TO BBA CICEPTBE
Data: 'I�h1121/e1a1El Permit Num1ber:
•
Building Permit Application
Fllainrincl tint Deveilapmeinil Services
fib ilairglana CLide REigluicition Llivisicin
2300 Virglinia / ve nuei, Fan Wei cei FIL 34 51f12
PHciriel: (71712) 4i1:1a-91993 Fiix: (7122) 410-]19718 Comrr ercial RElslidentlial N
RERMITI APPLICATION ROR: -no Select frorr ducipbax, c[6 arrow at ilhe end oil line
PRC POSED IN PROVEMEINT LOCATION:
Address: E13'11 C neer Dolplh in :11
I egal Descuipll iori:
Properly Tax 110 P:
Lot IS ci.
-'lite Hari Name:
Hlcick No.
Project IN arrie:
Sell t asks Nrarit Back: RigH t Sic e: Lefil Slid e:
DETAILED DESCRIIPTIC)N OF WC RK:
Insilall new shower pari arid pnoper two oiciry sl• ower drain in preparation fon nE1w dile.
CONSTRUCTIC N INRORMATIIC N:
Addil icirial mimilk to bEirtormed u n der this perm it — c Eic a apply :
❑
❑F VAC Gas 11arih ❑Ga!i Pipinpl _ SH utters Winc clan
3/Doors
❑ electric 0 Plumtirig ❑Spririhlens ❑ Generator Roof
Racif glitch
Tot al 9q. Ft of Coristru cd iori: !I Ft. of Finsl Flcion:
Cost of Corisl ru c1 iar : $ 499.aa Utilil ics. SlewEw ❑ `.lepltic Bu ildinig Heiaht:
OWN ER/LESSEE:
CC N TRACI9OR:
Name Jane Voyla-Pedersen ii� arr,El: Raul PEidersen
Ac c ness: 63111 Cneer Dolplhin91 Complaniy: Lit le Hear Plumbirig, Ina.
Cliff y: Rcirt RiEmae Il atEi: RL Address: E1959 1 a3Rd Ave
aip Cace: 31499'1 Fax: City: Vera Beach
Stale: RL
Rhoric Na. Zip CO( EI: 309671 Fax:
E-Mail:.ialriEirrivl9@clrriail.com Plhorle No. 717.1-388-3321
Fill irl fele simple Title Holcer cini riext palle ( ill difllerciril E-Mail: littlEiteainpIL rritinclClivEl.aam
from the Clwrier listec above) 'l1 atEl or Cou r 1 y LiceinsE1: C RC'14 218,116
If r alu a of ccinstru ctior is ; a9C10 au rricir(i, a F E(IORDED A atice cilCcirrirrcinic(irrienl is reiqu inec .
SLPPLEMEINTALCCNSTiRI:aw LION 0W INKRIMATION:
NamEI:_
A c dress :
city: _
Zi pl:
NG (NEER: _ Not Applicat IEII MORTGAC 8 COM RANINI: _ Ncll A r1pliaable
Name:
Rh one
StcltEl:
FEET SIMPIIE TITL8 HOEDIER: _ Not Aplpilicable
Narr Er
A c dress: 855:1 103RdPve
City:
Zipl: F h one:
Ac c ress:
City: State:
sip: Rh carie:
BONDING COMPANY:
Names:
Ac c ress:
City:
aipl: Rhone:
_Not Aplpllicat le
OWN EIR/ CC NTRPICTC R AFRIDV IT: Appliaa 1 icin is hEmEiby mace to abl ain a penmit to do the "ark anc inll allation as inc icatElc .
certify that na wank cIr ins) a llation has camrrenaec pinior i a the issuancEl of a pEinmit.
9t. LuciEi Clounty makEls nc1 iieppresElnl al ian that is granl inji a pEinmit mill autharizel 1 he anmit I cllc en lo H uild the sutjelct stnucturle
which is in conflict m i1 h any appllicad 16F amu OH news Assoaal ion nuIcs, bylaws cm and ca%ena nts that rrlay nElli nict cm plrclhibit suah
s1 nucl urEl. Please ccinsult w ith youn Fame Ow neris Assaciaticln and n(MEiw youn doled for any nestrictians whish may aplply.
In cansidelrlation of 1 he ®rant inji cif this requested pemmit, I do helrEiby agree l hal I w ill, in all resplects, penfarm them ark
in accorc ance m it h the appinoveid plans, the Alanida Eluilc ing (la( Els and St. Lucie) County Arrend mants.
llhEl fcillclwing built inEl peurriil a p pllical ions ane ex(lrriplt from undElrlplainEl a ilull aancutmElncy neviElw: nelclrri ac c it ians,
accessciry ltrualunes, swimming pcials, seances), malls, signs, screan nooms and accessory uses to anathelr nan-residelntial use
WARNING TO OWN EIR: Yau n failurei to Record a Nal ice of Commeiriaemerlt may reisc It ir1 y au n Flaying twice) for
improvements lo your rlroperty. A Nol ice of CommenaElmerit mI. st L EI rec arded arc posl ec ori 1 h EI jabsil EI
before the first inspacitiarl. If you interic to cit 1 ain firiarloinij, cions). It with lender) or an all carne) before
nnmmanrlina wnrk nr rorinnc inL7 vourl Ncil icle Of COmmenciElmEril .
Rev. 8/:I/]la
9ignalure of 01n nem/ I essce/Clans naclor as AElenl fan OwnEin
SliOnatune cd Cantnactcm/License Holder
STATS OR Rll
DPI
STATE OF FLCIF�QA
COUNTY CIRYLD
QICQ c
CCIU NTY OFT�YI���C
lhel ioxgclinEl instrurrieni
was a cknawlEidElec Blore mel
The fc�going ansa ent
this � c ay of,
s a knoN lest gbElfcme me
20 by
this) day cd
, 20 by
JEhUl
P11
N amu cif Alen
inEl sl al errienl
✓
N a of pl on making atElment /
Pensonall Knciwn OR Pita ficatian V
Rensonally Knaw n
OR PnocucEid IdElntili Tian
Ty pe of c e Ai
1 is
1
Type of Ice ' ' a ' n
rclduaelc
'e �L Z
Praduc c
(Signaturle cif
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(Si urEl of Ncll ar)l Rud I' ;, 11 d
Camrrissian Ncl.
LIE.I SBIIIIIETS
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clfTlrr l!llCln �a.
NA IN j� CrJLSBAIlIETS
Nol:u r7b�i 9t�t'.afFlorida
ar)l Public - State of f lorida
Commission Al CIC 189743
:;` �' Carnmi..iion AICIG 1119;43
My Ca mm. a xpiref Feb ] !, 202:1
N), Comrni. Lxpire� Fab 79, 20:1:
REVIEWS
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V9GETA11K N
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MANGRCIVE
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REVIOW
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Rev. 8/:I/]la