HomeMy WebLinkAboutSMITHLER2AUL ARPLICABUE INFO MUST BEI CC MPLETED FOR AFIRLICATICN TC BEI AC(EPTIID
Dater: RElnmil Numter:
Bluildin g Per m it A pplicatie n
Mcinri it g trod Deiveilcipmeint 5eirvicei
Bui)aingl aric Cciaei A eglulcil iori flivisicin
1300 Virglinis / veinuel, Fein Kea ei fIL 34912
PlhorlEl: (M) 41621-11553 Fax: iIM) 41E12-91578 CClmmerclial Re!Iidenllial
PBRMI-I APPLICATION FOR: -no Select from drorlbox, chick arrow al ire end oil line
(AIQ1� f, T'"l.UATIOR.
Ac c Iless: 1) Ok l _I'y
Loglal lhScripl ions:
Hnanerly Tax ID#: � �(i lU `— L'�/� \U— —V Lot � o.
Site Pllarl Name: Black No.
ll Namo: rn t --y
Sett abs Frarll Back: RiElh 1 Slide: I elft Sic el:
AC I=Gas111anIN I lGasHipiriEl L_1'.IPuttElna
Electric Ej Plum tirig OSFpiiriMers GerlEinialan
Total Sq. Ft of Conlstru ction: ',�•�, ((��
(Iasi of Constru cl iorl: $ �Ac � S-1 L J
Sq. Ft. 01 Finst Nlocir: _
L 1 ilitiels:1:1 9(l%A Eln 1:1 Sepl is
F]Windows/Daars
L1Roof Raodl nilch
Builc inn HEIiflht:
If v alu a of caristrL d ion is $719(10 or mane, a RECOFIDED 11 atice oil Cornmencemenil is ueclu inec .
I�I-riIRAC I�
Name 1
Name:"
Ac c ne 1 V�I1 C i
Comnarly
AddrEl9 s: _1 lig
U
(lit y: �� Still EI:
aiFl (lace: F21x:
city: l.%-(11�� J1 at( i:
Rhonci Na.
iligl Cac e: �3� 5 Falx:
El -Mail:
/
Rh arlel I` o.
Fill irl llee simple Till la Holc an cirl rlexl page ( if difilerelrlt
E -Mail: �_ MS -Q10 )D4 Ori i—. A/\,I
from tha Clwrler listed abo%e)
9atEl or Cat, rlt� LicElnlse:
If v alu a of caristrL d ion is $719(10 or mane, a RECOFIDED 11 atice oil Cornmencemenil is ueclu inec .
DESIGN ER/EINCINEER: _Not APrIliaaltIEI
Name:
Address:
Clity : StFItEI:
aiFl: FI r ci riEl:
AEE SIMIPEEI TITLE HUDE R: _ Not P FIFIliaalble
Nairne:
Address:
City:
2Iirl: RF ariEl:
MORTGAGE CICIMI PAIN N :
Nairne:
Add HIS S:
City:
aip: FIN one:
BONDING COIMIPAINY
Name:
Ac c ness:
(lily:
aipl: P11cirie:
I certify that no %n ark or installatipn has carrimenaec plricvn 10 1 he issuance till a plenmit.
_ Not p ppliciablEl
Sta11 EI:
_Nal P FIFIlicaiblEI
51. 1 ucifi County makes np nepine9entation 1Hat is €lranl in€l a plermil %&i I I aw haniae 1 he plecmil hplc eu 1 a built t he sutlject stiiuctunfi
whiah is in cc inflict w it h any aplplicat le Harrie Ownfms Asspciatipn nules, LN Ia%n s ar anc covenants tIi at rriay nest vitt or pinphibit suah
stiiuctunfi. Pleasfi cansull with ypur Harrie Owneuis Asspciatipn and rEivie%n your coed for any nestrictipns which rriay aplpIIN.
In aansidfinal ion of 1 he @rant in€I of 1 his reclumI ec penmit, I do Ilerall y agnea that I will, in all rEispEials, plEmfanrri the wcinl
in accorc anae w ilh the appinovEid pIlan i, i hfi Flanida Built in€l Clac as anc St. Lucie Clpuniy ArriEinc rrienls.
Tlie ilollcmin€I built in€I plenmit aplpllications ane exerriplt from under€loin@ a lull ccincurnency review : roam acc it ions,
accessary struatuves, swimming plapls, fences, walls, signs, scuefin rooms anc acce»ary uses tp anolhen non-nesic enlial use
WAIRNINC TO OWN E R: Y av r faddiie to Record v Nailicle of Caimmenclement may result in yoL r paryirig twicler fcm
imptiavements la your Fplarp . A NoticiEl of COMM ElrlaElment mull be rlElaorded aeric FlostElc on the jobsitEl
t efone th EI first inSrIElCIticiri. you iril EIrIc to cit 1 alin firlalrlciir8, cior1SL 11 wii r IEI Elr n a1r1 �Ittorney k ElfouEl
commencina worNjCHYEICQfdirig you r NoticiEl of CommenaElment.
Signal ure oll "no fie/Contractpn as A€lent ton Ow
STATE OF F
CCU NTY CIFI
Thee pin€linstru tHasackncmlec€le eikineme
this dal pf� A 210 E by
o_L,rAA'0C
INarrie cVDEirscin ack lac Pal a )
Signal uu 'I ary PLA
a ly NI naw n _
yple cdl Idem iilical i n Pn(
"sr"•,,
missipn
Rlevised 07/1 14
is Sl ate oil Flpni( a
-OR P
P 93
.PA on 1
spa e�^
se Halc or
OFI FII
CU NT
COIU NTY CIH_ � u
Theilor ing instru 1 was acknowiEid€let efarfi rrie
thisaldal of ala rciSIO by
� 4 mf) C
(Narrie cif plerspn aaknawled€lin€I )
ue oil INbtaWPu
cin Perspnally Kliomn
Type cd ldfinfillical
Carrimissian Np.
e pll Floric a )
OR Pnpc
v„,..
Ion Fr'da 019
Clomtn` Novemt -is E.
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