HomeMy WebLinkAboutBuilding Permit ApplicationA��APPLJ,CAQIJ )JINFO MY -FT OE COMPILE-'V nRAPP,41-CiATI-On TO [05 7EPT149
Date:. Permit Number:..
C:
SulIdling Perrinkoplicallion
p/Qn,,nin� Q�d Deyelopm, ent�erytces .:
Vuitding an, d Cod_e;Rf ggyjotipn Lojyii�ion
2 90 �ir ?n, afdyenue,1Fpt, .Pier, FL 4
Phone: (772) 462-1553 Fax: (772) 462-1578 . Cot7 merdal Resldentia1. X
... . .... . ... ..
PERMIT A,P,P ICATION FOR:, lRWiiJS
PROPOSED IMPROVEMENT LOCATION:
Address:
1,3994 .8,0 .. .
Legal Description: 'W704�W All Ittait-pertllyirV: igodheA�(ter1y(0f11_06
Property Tax ID #: �1'W111-�199t1409110 Lot No. .
Site Plan'Name: 6PAN .WH, LLA UF.AIMA,Y6 Block No.
. . .
-Project Name:
.. .. ... .. .
Setbacks Front21" Back: 25' Right Side: 2.0 'Left Side- 2.80
DETAILED,DESCRIPTION OF WORK:
II�IOJL� !Fpll(IfLY IRIEIIO�INI�r�p,lacmon I,me).: BEDROOM // IBAiT1M I GAR, G�O
NO SLAW WJL+L. BE 11 UILL`IT OFFREAR OF HOME
=CONSCTION fNFORMATION:
Additional.work to be performed un e.r t is_permit-,check, all apply: ,
�✓ HVAC. tJ Gas Tank Gas Piping Shutters a Windows%Doors.
Electric. Plumbing Sprinklers Generator Roof
Total Sq.' Ft of Construction: S . Ft: of First Floor:
Cost of Construction: $ WOOD Utilities: Sewer Septic Building Height:
OWNER LESSEE:
CONTRACTOR:
NameWN�N. SUJ1�U� G WRP..
Name:- iMllWKEtuJ VY1 iEWY'NKE' ,
Address: W09,69 l H VSHWY. 11 SUITlEA02.
Company: EJ�0NTaQRP..
IF�.9RT aT,111U9,IE lFll:.
City: Statei
Address �U00JmFil IUS:IHY. n :UI1fiE .�Ac02 -
_
Zip Code: �2. Fax: i(772) 87,6-7
City: (F� R\ TI .ST, ILW1 1E :. State: �. .
Phone No.Ci72):�7�i1
Zip.Code:42 Fax: (i77��)ffi"7-7i6'6
E-Mail:
Phone No. ((772�)�817&1%13 .
fill ,in:feesimpte.TiitefH9ll cenineldlpaie1(_iifdti,erarn
E=Mail:.
frairThe Owner. CrsW4 .Ahoys)
State or County License:
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/MIKE-Eft Not Applicable IM ,i3T�GGASE(COMOAiNYa Not Applicable
Name: IBRAQENAORADEN
Address:4',7,c;Q .QDIUT,AVE
.City: 'STPUART State: !FL
Zip: 34996 Phone:.(,7;7.2)287ia258
FEE 5aM.P4j~TitT,LE-IIHOIDERL _ Not.Appli.cable
Name:
Address:
City:
Zip.. Phone: -
Name:
Address:'
City: State:
Zip: Phone:
l$0;�101,1�ISiCO,IIP,AiJIY: Not Applicable
Name:
Address:
City: .
Zip:._ Phone:
I certify that no work or installation has .commen ced.prior to the issuance of a permit.
St Lucie Countyy- makes. no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association 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 considerationof the granting of this requested permit; I do hereby agree that l will, in all respects, perform the work
iin,accordance with the approVed plans; the Florida Building.Codes and St. Lucie County Amendments.
The following building permit 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
111J1i1RNl:i if0:iU11JlNE!R:�Y*urifoil rettolft or INS e aftemmerwameritirrtaytr sitl [in,n�Y rlpaYingitaeimefor
improvements to your property. A Notice of Commencement must be recorded and on the jobsite
before the.fi.rst inspection. If you intend to obtain financing, consult with lender or -an attorney before
commencing work or record i nizvodr Notice of Commencement. .
Signature of Owner;/ Lessee/,Agent Signature of Contra c or/License Holder.
STATE OF iF�UMIDA STATIE OF IMORIDA .
01M, TY OF 5� � Gc [" : �G0�,1YT1Y �O,f S'� . �-e.�c�
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this _..Z_L day of _-rq AY IGby . this 'c;L I day of -o Ay
(Name of person acknowledging) (Name of person. acknowledging)
(Signature of Not ry Public- State of Florida) (Signature of No Public- State of Florida )
Personally -Known f/ OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. - ,.� �P„�,, DQROTI(19eAIP;18ASKIN Commission No. „.,�„
. ,..,a DQRQTH ASKIN
MY COMMISSION # GG 030145 ' ��` ° MY COMMISSION # GG 030145
Q5 0
EXPIRE-
6onden Thru Notary Public Underwriters 's�F ��•
Va �d i(JJ/Ii'S,I :,,,p� d�,,• Bonded Thn, Notary PuGic UnderwAters .
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
-MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW,
REVIEW
REVIEW
REVIEW _
DATE
-
5O,IYIIP�I�TIE
I1Nil IFIAL2