HomeMy WebLinkAboutBuilding Permit Application ALLAPPUCAKERM LOW iEc1G. . .WFORAPPUCA'!it'fHITOBE ACCEFTEID
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Building pemilt Application RECEIVED
OCT 2 2 2019
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PERMITAPPUCARON FOR: - 11
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PROPOSED IMPROVEMENT LOCATION:
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Pr FNW Tax ID#: tot No.
Site-Plan hi me:~ Block No.
Setbacks Front Back Right bide t eft Srde
DfT ILED DEsaupr'iON OF WORK:
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—HVAC _6asTW& _„6as piping _Shutters ZMfindowrs/Moors
_„_.Electric _..:PkmxbWg _...Spdnlders ._Generator _Roof Roof pitch
Total Sq.Ft of Corsstructim _ Sq.FL of First Floor.
CostofConstruction:$ 'Q Utilities: •_.._S __..mac Buil Height:
C1VN4l4ER/LESS CONTRACTOR:
Name 11j%IS Of Hayne: _ f
address=.Vi —" Y: -.' t
Mr. i"yZ lej:gL-e-" FL�,'i4�_ State:, Address: �.i�
Trp code: Fax;__ 0Y: 6cL
Phone No. -1 7.) 3 Tip code: '-ARtt a Farc
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f mt j State os County license
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SPAY p„B{ VERED WEINSTOCK
Commission#GG 178187 �� r pue4� VERED WEINSTOCK
* 23,
2022, _ ``.,..' Commission#GG 178187
* 4 Expires January
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SUPPLEMENI'At CONSTRUCTION LIEN LAW INFORMATIC?N�
e ti
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
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: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize thepermit holder to-build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home 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
in accordance with the approved plans,the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/Lessee/Con ractor as Agen for Owner Signature ofContractor/License Holder
STATE OF.FLORID STATE OF FLORIDAA,,_�
COUNTY OF �" SI. /L)t( z` COUNTY OF /,1Df
The forgoing instrument was acknowledged before me The orgoing instruLnent was acknowledge me
thi day of d�'� 20�.by thin` day of 20 by
Name of person making stat ment. Name of person making statelinent.
Personal own R Produced Identification Personally Known R Produced Identification
Typ Identificati n Type o i nation
oduced 1�;"�®i,� VEREDWEINSTOCK uced a��`;;°e�, VEREDWEINSTOCK
* Commission#GG 17818 * a Commission#GG 178187
hq� Explres January 2 22 \oe Explres January 23,2022
F4Q� 9ondedThru9udgetN ryServices FOF oQ Bonded ThruBudget Notary Sarvloae
o ary Public-Stat of Florida) ig re f Notary Publ' a of Florida)
n No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION 'SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19