HomeMy WebLinkAboutBuilding Permit ApplicationAMtiPPL1CABtE INFO MUST BE CpM' �ED FOR APPLICATION To BE.p" .
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Permit Number,
)IAW WLMC Building Permit ApplicationL
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P/anningondf-14dopmeit&Wc�es . DEC 13 2019
Building and Code Re�gon oh*kn 23W V1119kinAvenueFortpleme FL30FI..cie county, permi
Phone: (772) 462-1553 Fax (772) 462-1578 Com mercial
Resident
PERNIITAPPUCATION FOR To Select from d
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Address: 000 Alic aA 1LQ vie /L'/^ / r ERCt
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PmParty Tax ID l009
Site Dian Name: 1. fefr�A 1 7" r, i� Lot N. S,FIo
ProJec¢Name �tw►i1.0 J. T,�,Nr Block No.
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Gas Tank _ pipingShutters
_ Electric`^ _.. Windows/Doors
_ Plumbing —Sprinklers _ Generator O
Total ft Ft of Construction: _ Roof Roof pfth
Sq. Ft of First Floor -
Cost of Construction: $ 3t�00. C Udl ies: _Sewer S
— ePBc Building Hecht
(l1A/R1Co'heec�er.
Zip Coe= �. _ Fax: State
Phone No.2- ii0 - /00pa
E-Mail:�I�no
Fill In fee simple Title HW&r on next PWAI Ndf .sit
tram the Owner listed abode)
Name: N O
Company: Caw Ro E
Address: N WY .
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DP Code: y 9190 Fax
Phone No.
state or County Ucense: O mqCQ tf
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Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE W01DER: — Not Applicable-
Name:
Address:
City:
ZIP: Phone:
MORTGAGE COMPANY; _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:
Address:
Zip: Phone:
_Not Applicable
OWNER/ CONTRACTOR AFFIDVIT; Application is hereby made to obtain a permit to do the work and Installation as Indicated.
I.certifythat no work or installation,'has commenced prior to the issuance of a permit
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which is in con ict with any applicable Home Owners Assoc permit
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 buildingpermit 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recordine vour Nntir_p of rnmmonrcmun+
STATE OF FLORIDg�
COUNTYOF K`0xl��
The forgoing! nst�um twasaclnnwledge before me
this�dayofy ZO�by
STATE OF FLORIDA
COUNTY OF
The fo oing in ument was acknowledge before me
this' day_14 oby
INIS� ��oyJ
(Name of person acknowledging) (Name of Pefson acknowledging)
(Signature of -Notary Public- State of Florida)
Personally Known �_ OR Produced Identification
Type ofIdentificatinn Produ
//1I/ 3 " 4,,, BRITTAN'f
Commission NotY-) /90 StgrmNf Florida
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REVIEWS I FRONT COUNTER I REVIEW ZONINGS REVIEW
Personally Known OR Produced Identification.Up_
e of Identification Produced
I mission RITTANY F
g of Florids•N
'y •e Commission M G
,M Commissioi
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PLANS •VEGETATION S
REVIEW. REVIEW- REVIEW I REVIEW