HomeMy WebLinkAboutBuilding Permit ApplciationSUPPLEMENTAL CONSTRU CTIO N LIEN LAW WFORMA'nOW
Not
Nafo:
Address;
-City, ,
Zip= Phone
FEE SIMPLE THE HOLDER: _ Not Applicable
Na rrle ;
Address; " -
Zip: _ Phone;
MORTGAGE COMPANY, _ Nazz App licab le
Nam:
Add re :
City: State: —
zap; Phone;
BONDING COMPANY: _N of Ap pl is a bl e
Name;
Add
City+. ---- - -
Zlp; Phone;
OWNER} CO NTRAUOR AFFIDVFT. Applie;ation is hereby n*de t4 obtain a permit to db the vmrk and inswlilation as iindiu led.
I aarti fy th;31 nu work or installation has commenced prior to tht issuance of a permit.
St. Lucie Countty makes no representation that Is granting a permit wc�� ill auth'the @ermit holder W build the subject structure
whfoh is in eonRf{t with any appiLcable Home Owners Asso6atlan rules} bylaws or and covenants that may restrict or proh ib;t such
structure. Plea se consult with your Home Owners Association and rewiew your deed for aYryf restrictions which may apply.
In wnsiderot�un of the granting of this requested p Fmit, I da hereby agree that I will, in all respem, perform the work
in acrardance with the approved pdans, the Florida Budding Codes and 5L Lude uurnty Amendment%.
The following building permit appdicatians a re exempt cram undergoi ng a full concurrency review: room addktions,
acecsseTV strue#ures, swimmi rig pools, Fences, wa Ils, signs} screen rooms and accessory uses to another not -residential use
'I'1 ARNMIG TO O4y'NW- YOM FAILURE TO RiErEOM A 111)71EE OF ❑OM Me11MlE T MAY RESULT M YOUR PATINC
T"WE FOR NPRaVEIMENTS M YOUR P 1`tt- A II OTHM Of Q MONEW ME111T Nk.!!�i 6E RECOIDI M AND
POSM ON THE J013 SITE BU�0111lE THE MST E15PEETIONL F YOU WrOW YO ORTAI1 FINANC3I0C, EONSULT
WITH YOUR MMER Ott AN ATTOMEY BEFORE MK RMW YOUR WTI QF COIIl1WMCOW F,"
• I
Signatureo: O rriCtor.35 AWL for O,tmer FLmnotu7t ref C*n 1der
STATE OF FLORIDA STATE OF FLORIDA
7h,- forgoing in$Vum L ar imledged beltwe me
hi c da of 2D 2A by
N, ira dt per.wri mwking �L YMLnt-
%fSOnally KnOrwn I OR Produced Identification
Toe of Iderltif iuticm
Produced
The faTFping instramen s a knowledged before me
the of 2� bylwv-
l e+t 7�1
Na of 04p011 m'Sking �M vrl'.
Personally Known?rodue�ed Identification_
Type-0f ld ,aWn
?Siknujur.e4d Kr� rAPublir-
L nature of f yr Publ
5 .� F f i+ a E F R ES N I LLO
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S{ `••�!,IrA %11 Florida-Naiafy Publi
�do :G 272747
r a ;,ytc�. my arnmi ssian Expi-
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T' 'Y1 rr i'ir9Si0M
4crn h, �r 3, 20?
1 r��►t}t}ar 22. 7077
REVI EWS FRO NT
ZO N ING SU PERVISf}R
PLAN$ VEGETATI ON
$EA TURTLE I MARGROVE
COUNTER
REVI EW REVLEW
R EVIEW REVI EW
R EVILW R EV iEW
DATE
RECEIVED
)MPLLrL1)
Al I .DPP=ICASLE INFO MUST 6E COMPLETED I.OR APPLI CATION TO BE ACCEPTED
Daze:
COUNTY
r r a R 1 r.
rrwp arvd �rr�efrt 5e�urc es
& Ri ng and Cudc RegwJilriarr Diuis�rr
2300 VF rria Avenwc, kA Ph!!ree FI34992
Phone; (7{2) -L',53 Fax- {T74 4152-1578
PERMIT TYPE:
PROP05FD fNPROVEIVIENT LOCATION:
Permit N um be.-:
Building Permit Applicafian
CDm me rei a I Residential
P-oPcrw Taxi[) #b -5y ' ,YTS.' _ V3 .z Los No. �v
Site Plan Name: Uxk No_
Prraje�ct Name!_ Y --
DEfAJ LED DESCRI F'TJON OP WORK:
e74 -rL4; ale t�-
CO NSTRUC710 N I N FORMATION:
Addit.r mal work 10 be &wrforrned under #kris wd�rmiz— ChKk all that aPPV-
_Mechanical _ -Gaa Tank _ C;as Piping _ Shatters _ Windorws/Dvjr�
Elect r-C _ Pluimbang _ Sprin k ers _ General -or _ Rc*f Pi tch
Total Sq. Ft of Construction:
CAM *1C*e4 rwUaq;
OWNER/LESSEL
Nlame ,7�_..
Address-, - T Lv -
zip code: J ti JJ�& Faac
E-l Wil:
Sq- Ft of First Floor_--
Ljt11itie3= _sewer _Septic $rlildir g Height:
Fill in fee sirnple TTtie Holder on next page ( if different
from tha Owrrcr fisted abQ+eI
City•
?ip Cade: .s Fax:
Phone ND�
E-Mail -t L i to 6
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it value of Wnytr1omon Ps!, 2500 or more, # R rPECIED Nabra of €brnmeraDemeret is required.
fE wales of HrVAC is $7,W -or moan, a RECORDED NntKe 0 Corn mencemenx is. required_