HomeMy WebLinkAboutApr 13, Doc 1All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO ISE ACCEPTED
Date:
r4otq. -
U; NTV. 4, �
Planningand Developmenr Services
Building and Code Regulotion Division
2-300 rf-'n A uoz n i io Fns Dian r . A 02
Permit Number
Building Permit Application
r
Phone.- (772) 462-1553 Fax--,(772) 462-1578 Commercial Residential
PERMIT TPE:
PROPOSED IMPROVEMENT LOCATION:
Address:%r
Property Tax I - —.7 C-) 0 l Lt �C40 Lot No.
Site Plan Name.
ProjectName:
DE7AILED DESCRIPTION OF WORK:
Block No.
i -R. Lam.
?\�c- � rJrj MAV 2 G Y�.`�
v
ec-0
J, ;--: L4 !�6.
I r n +�e N , TWO A rr'tcand �tAril rn U n
I, CONSTRUCTION INFORMATION:
f aaC_ 19Law�,
Add iti nl work to
be performed under this
permit—
check
all that apply:
Mechanical
Gas Tank
Gas
Piping
Shutters Windows/Doors
.S51ectric
_ Plumbing
Total Sq. Ft of Construction:
Cost ofConstruction: COD
OWNER/LESSEE:
Name ('c.d-+&r U11 6
Address: I0 U�0 s uu k+cL~AtA.wti
PrinkIer
Generator
Sq. Et. of First Floor:
Roof Pitch
Utilities: iSewer Septic Building Height:
City: - P
&L State:
Zip Code: Fax-,
Phone No. '-r, -& q Z,4 &9/
E -Mail: C(;11(g(_Rq;7,q5b 11yA A I L
Fill in fee s*Irn pie Title Holder on next page (if different
from the Owner listed above)
CONTRACTOR:
Naf7'iQ:�r[.Odb;J 1I t.'s
Company:C c��I�S _ (�(,�c� f{N'c Nre
Address. Voib
L^J
City: PS L, State:�L
Zip Code:. �.� y4 Fax:
Phone No *�71 70
E-MailCvllr5c
State or Cvunty License EZ 136;:jL-1 � 7
If value
of construction i
500 or
more, a R SCO R OE D Notilce of Cornmencement is required.
It value
of HVAC is $7,500
or more,
a RECORDED notice of Commencement is reuir d.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: � Not Applicable MORTGAGE COMPANY: _Nat Applicable
Name: Name:
j; Address: Address:
City: State: _ city -1d? State:
Zip: Phone zip:. Phone:
FEE SIMPLE TITLE HOLDER4
: _Not Applicable
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
City*
zip: Phone:
Not Applicable
OWNER/ CONTRACTOR AFFIDVr IT,: Application is herebV made to obtain a permit to do the work and installation as indicated.
1 c rLithat n ��rork or insrailation has commenced ,prior to the issuance of a permit..
St. Lucie Countv makes no representation that is grartirg a permit will authorize the ermit holder to build the sub) structure
which is in cont, I CO Wil., appion rules bylaws or ancov nants that may restrici or prohibit such
structure, Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
I -d tion o the grantingo this requested permit, I do hereby agree that I will in all respects, perform the work
inc rd niC with the approved plans* the Florida Building Codes and St. Lucie County Amendments.
The fodowing buil is perm is applications are exempt from undergoing a full concurrency review: room additions.,
accessory s: �'u res, svvirrrring pools, fences, Walk,. signs, screen rooms and accessory uses to another noir-iresrdential use
"WARNING To OWNER" YOUR FAILURE T RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TW10E FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POS N THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
YOUR LENDIER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT"
atu e of Owner/ Lessee/Contractor as Agent for Owner
STATE DF FLORIDA
COUNTY OF SA
The
forgoing
instruMent
was acknowledged
before me
this
day
of Aro
1 20 Z6
by
EWaN
(C'
Name of person making statement.
Perso n a.l li Known R Produced Identification
Type of I d roti fi cation
Produced
(Signature of Notary Public- Sta e of F ori a
�YXMISSSION 4tiCommiss on REJAN 01, 2024
D throuo,Isf Stale f I!4-
5' nat re ContractorjLite+�5e Holder
STAVE OF FLORIDA
COUNTY OF
, 4� -t J
The forgoing instrument was acknowledged before me
this 3 d a of - � vb�
u 61
v t I 1 s.
ame of person making statement.
Personally Known n Produced Identification
Type of Identification
Produced
(Signature of -Notary Public- State
r.
Commission No. 3 sw I to
o ria
6 a
Eh a t.
REVIEWS
FRONT
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COUNTER
RaVI IN REVIEWUPERVISO�
REVIEW
EWaN
EY E►WLE
DATE
RECEIVED
DATE
COMPLETED
ev. 277719
MANGROVE
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