HomeMy WebLinkAboutBuidling PermitALL APPLICABLE INFO MUST BE COMPLETED FOP,AAFi•tCATtON TO BE RGCi;P�umbar:
Permit
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Building Permit Application
planning and Development Services
Building and Code Regulation Division4982 QSia�n�l�i .� ---
2300 Virginia Avenue. Fort piers Cgmmer.._. _- R
Phone: (772) 462-1553 Fax: (772) 462.1575
PERMIT APPLICATION FOR: To Select from dropbox, cllck here
PR�AOSED`�N�R01l�M�E'NT`I:QCATIpN.`•�� Yk S� - �.�,
Address;
Legal Description: �i 5 yti: lip
Lot No.PropertyTax lD #� : � �U`� '` �L7' � i�.'�
Block No. l 1
Site Plan Name:
Project Name:
Setbacks Front_... - Back_. Right Side: Left Side:
�±LAf L p DfSCR1PTION.OF WORK
'Me
w 30' Q%4 Lod 'Jer -h " o`EL
CONSTRUC lON iNFORMATIaN.
—
Add tlona I worK to e e orme under tis per , —e ee
0HVAC Gas Tank OGas Piping
a app y:
Shutters Windows/Doors
_
Electric Plumbing []Sprinklers
� Generator � Roof
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ } C� Utilities:Sewer E Septic
Building Height:
OWNER L'86'EE;
C�NTRACTO'R:.
Name U JI I 1
Name: ;Do N M (li' / bA
Address:. %A'uSt lyl� C, ll�L
Company: of (e- r�l �tI(•�i��C l C'c 1
city:�y �-' ,ldLl�._..., ,_J _State;L-
Address: 40) 1� ��,APR456' Dl�t�f #186
QJ
Zip Code: C��' Fax:
City: �DO)C7 i Luc=I If.' FL
Phone No, * ^�
Zip code: Fax. Fax: 7V -87
E-Mali: - _ _
Fill in fee simple Title Holder on next page { If different
Phone No. 77'__
E•Mail.
from the Owner listed above)
State or County License: Cr 1
If value of construction Is $2500 or more, a RECORDED Notice of Commencement is required,
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Name. Mate; —
Address;
City: phone:
Zip:Not Appiicabie
FiGlr, SIMPLE T171.E "OLDER: -
Name; ,..
Address:
City; phone:
Zip. ,....-- .._---
ddress;
City;
Ztp:.r.--------- Not ApIlcab�e
13p14D1NG COWIPANY; "
Nature;
Address;
City. Phone:
Zip:.._-.--�--
arm"- subject ructure
prior to the 155uance of 2 restrict or pro�lbit such
a errr►it will authorlae the permit holder to build the subj
l certify that no work or lnstalVatlan has comr<lenced p b laws or and covenants that may
no represe t tion that Is, granting p Cestrictlons Which may ap#1lY'.
5t Lucie Count rnak a ii,DNS' Marne Oners Association rules, y acts, perform the work
which is in con lctw any Pp hereby agree that i will, In all rasp
e, please con$ula with your Dome Owners Associatiodnn and review your deetl for a Amendments,
structur of this raque5ted permit, l Amen
in consideration of the granting room additions,
undergoing a full concurrency revie nofiher non
-The in accordance with the approved plans, the Fla r'sda i3uilding Codes and 5t. Lucie County
Permit appllcations are exempt from uses to a
The following building p ools, fences, walls, signs, screen roams and accessory our paying twice for
accessary structures, swimming p result in y p Y R QbSite
Notice of commencement must be recorded
and as�~ta nay befted on the ore
WpRNiNG TO OWNER, Your failure to Record a notice of commencement may
irrl rovements to your property
_ .,.,.t,e�lret insnectlo-►,_1'f you intend to obtain finannrergrt',rflnsu
_ M PP
Sjg+ atdre-,nf'Ow6erf Lessee/Agent
STATE OF FL, 1(3�A
COUNTY Of
The for ping Instr ant was acknowledged before r ' � 0
this �hiay of , �' za � by N0,9
• C's 82
i (Namepf person ack owleoing) .4� R
(signature ar Notary rup11C- blase or riurloe I
Personally known �OR Produced Identification
Type of Identification Produced
Commission Nlo,- `" f (Seal)
Revised 07/ 15/2014
STATE OF FLOR `
COUNTY DF - � Z
The forgoing lnstr entwaskacknvwledgedbeforem �
this � day of �' l C 10 by .10 ; 2
NName of pfirsan acknowl
of *tary Public -
Personally Known i. OR Procuced Identification .'.
Type of identification Produced
Commission No. Kf ���`Ul (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLAINS
VEGETATION �ATUR
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW I£yIE
DATE
COMPLETE'
INITIALS
TLE I MANGROVE
W REVIEW