HomeMy WebLinkAboutBuilding Permit ApplicationAEI A RPUCA$LE IWO MUST BE COMPLETED FOR APPLICATION TO $E ACU PTED
Date-
.
P1aminp ard Development Ser%dces
&v7dfnq cmd Code JReg+ulratran Div&jorr
2.TE6'Arffinro.gypr54Ae, Foft Pierre FL_W9G2
PhDne: (777) 462-1553 Fax: (77;t) 462-1578
Pe-rnaZ N umber:
Bu 1Id it ng Perm it Ap p 11 catio n
Com rnerdaJ Residential
PERM FT TYPE: I
P ROPOSE D [still PROVE MENT LOCATION:
Address:
Peoperty Fax iij #: _ �{ y — +`-j Lot No_ ..
site Than Name: Block No_ ,
Project Name:
OETAI)_F D DESCRIPTION OF WORK:
CONSTRUCTJON I N FORMA'DO Nr=
AddrtJonaf work to fit purfarmed under this permit- checkall that @POY:
_Mech,oAcal _ Gas Tarok Gad Piping _ Sftutters _ VVindows/Doors
Zet.ric _ Plumbs rkg 5prinlders Generator Roof P itch
I otaJ 5q_ Ft of Constru{tlon:
Cost of Cnn-imctign: � . o
OW N ER/LESS EE =
Haan e
Addres3:
Zip Code:__04 fax:
Phone No_ , -
E-F11a1:
Sq_ Ft- o F First door_
Lhli ies: _ Sevrer _. SaP-,Jc 8uildir4� Height -
Fill irl fee 5ienple Title Liok�eir oin next page (it ci-ent
fmTn the Own -or Ifsted above)
C04NTPAC-FO R:
Name:-
�ornpanw;
,Address:
City:
zip code: Fax_ r u
Phone N o -
r St". or CDu nrty Uuse
If vakm cf ounstru{tion Es 52900 or more, a RECORDM Notice of Commer ement is mgmhvd.
K wahae of HVAC is $7,500 4jr mare. a RECOLRDEB Notice of Oommew5em 4 reWired-
SUPPLEM ENTAL CONSTR U CTION LIEN LAW INFORMATION
IDESIGN ER/ENGNEE R: _ Not Applicable MORTGAGE COMPANY: � Not APplicaMe
Name: Ka M-�:
Address: Address;
Cftvl _ 5tne; City_ state,
Zip: Phone Zip: Phone:
FEE SIMPLE TTnL HOLDER: Not App icabF& RO N DfING COMPAN Y, _Nat Applicable
Na me: Name:
Add ressAddress: __-
Y=--
Zip- Gh Z. - Zip:
OWN ERI CONTRAGi OR AFt I DVIT= ApplkAtkM is kTeby made tip obtain a peru t to do the work and installation as indiQttcd.
I certify that no work �`r inVAlla#porr has oxnmenved prior ta the imuance of a permit
St. Lucie Cou" niske% ni) icprewnta5on thiFt is gaantiircg a permit wi® arrthorL-0. the perrr,Lt hoWeT to build the sub?ert strut-wre
which If irr Conflict wn with any applicable Home Owners Assadation ruIe�, � *r a�rci covenants that may r estria air prohiM such
structure_ Pleaw amsuft With your name Cvrtcrs Association and renew your -deed for any restrictions v thiich m�LY apply,
In consideration of the grapUnj1 -ul this requested permit 1 do hereby agree that I will, in all r�.cp , perfosm the work
in -ucujrdarrce with the approved p4ans,, the Florida &dldi(e CAodcs and St, Lurie County Amendments_
The faldowirrg bupding permit app€icatiw-s are cxc mpt from andeWirg a fuel amw-u -rencyr review! n&orrr acle6tipns,
acces +rV strucWres, Swimming pools} fence}, walls, signs, screen room ancF aas$ory uses to another non4esidertti.al use
'WART: TO OWNER' YOM FAILURE TO RECORD.A WrX1 OF =MMCSMSvt MAY FMSULT W YOUR PAYWIC
T"FOI FOR NPRIO►'ElMI EMITS TO YOUR PROPERty. A POUTICE OF W14fa11E110 MIENT NRAST BE RECORDED AMU
POSTM OdY THE JOB SITE BED O RE THJ� 19RST FMISPEC6i W F YOU NUTEND TO 01WAM FMLANCINO, CONSULT
WFTH YOUR LENDER OR AN ATTUffMEY BEFORE TOUR RUTKE OF COMMENCEIIINEAFi.71
i;a#ure of }�etQP$a]t br
STA F9UOA
COU NTY OF
The torgoing instrument was t«'wr�xt cr before nae
this I U do off._. � 2U� by
Name of person roaking statemi�nk,
Personally I(newn Z OR Produced IdentiTioation
f icde"tification
used _
7nature-of Notary Public -State of }�rida a F
u55iort N*6d �,,Za-y I]
71
REVI EVVS t RO PIT M NI GG -sup
i COQ R REVIEVV R
....
DATE
RECEIVED
DATE7119
-
C�A+LPiETEU
fetir_
110dcT
STATnF FLORIDA
COUNTY OF Q .
The fa%aing instr-umzi ,ht was admowkdge+d hefbre me
this jZday of "n�� few
J
Name of person. making aa*eni?nt.
Personally Knowrti OR P%-Jutcd bdentirication
Tvpe of ldcnMication
Prodleed
LIL
/I"—
ignature tart'LO uhlic- 5:a# r,f Po I i Ja )
VLGETATION 5EATLI TI F
REVIEW REVILW