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Date: Permit'Number:0 1
■
NNW c
Phone: (772) 462-1553 Fax: (772) 462-1578 . ..Commercial - . Residential X .
PERMIT.APP_)CATION FOR:
PROPOSEDI,MP bVEIVlENT LOCATION:
Address:§
.Legal Description:.€���./`��li9e .
Property Tax ID lell Lot No
Site Plan Name: P W& LLA ANLE Block No.
Project Name:
Setbacks Frontgg' Back: b9 ' Right Side: 11-9Left Side: 24
I.bEfAILED-DESCRIPTION OF WORK:
71
IR P e��I����� � �����o;�!� ��� �� �� �i9' l
CONSTRUCTION INFORMATION:
Additional work to e J performed un er t is -permit — check a apply:
ZHVAC. Gas Tank �Gas.Piping _Shutters. ir.. i Windows/Doors
® Electric . D PlumbingSprinklers 0 Generator Roof.
Total Sq. Ft of Construction: P49-4 S Ft. of First Floor::2:
Cost of Construction: $ $50,000 Utilities: Sewer Septic -Building Height:
OWNER/LESSEE:
CONTRACTOR: -
Name",nnetii£uiwn t •..
Name: �Atl8: ewO:*\llyymRe
Address: 8999 Smut SUS It M,11 SWW402
Company: VWAM-elDVv*lI009ienitCWF-
City: Port_st• Lwie State: FIL._
Address: BODO SyAt'h L; ililWy.1 Stiile42
Zip Code: 2 Fax: (772) 878.76M
City: lP*jt.St..I u0ie.. State: fF,L. .
Phone No. (772).67 113'
Zip Code: g4952 Fax: (77—�) WS-76W
E-Mail: 'Ohl Ori@wynn,eb=m,
Phone No. c(7 2) 878 3
Fiji up.f'eg gimp7e'at1e lHold r mn.nW page I if Afferent
E-Mail: dWouynrosbb.JaM"
from -IbeOwner{kisted abov#)
State or County License:
afi �►�� ���9� itS.�Zr9.0 mr �OrS, � 33EZS�.F3�E�D U�lo ��^±meneement uS �Lfired.
SUPPLEMENTAL CONSTRUCTIOWLIEN LAW INFORMATION:
DESIG lE 3/NG InIEE 3: . Not Applicable
MORTGAGE COMPANY _ Not Applicable
Name: ;Braden,&araden
Name:
Add ress:,41 ,coconut -Ave.
Address:
City: State:
City: Stuart State: FL
Zip: Phone: (772)287-0258
Zip: Phone:
FEIESJMPLE TITLE HOLDET3s.. — Not Applicable
B11mim coAIJPAim. Not Applicable
Name:
Name: .
Address:-
Address:
City:
City:.
Zip: Phone:-
Zip: Phone:
I certify that no work or installationhas commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the ermit 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, consideration of the granting of this requested permit, I do hereby agree that I will; in all respects, perform the work
ii,n 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
WARNING TO OWNEFL- Your f0Sasue.-o Rewrd a Motrim of Camrnaeamment may u It In your;payb3,g itwJce fo r
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 recording vour Notice of Commencement.
_ Signature of OwrierJ Lesseeffigent
Signature of Contractor/License Holder
STATE O/FLORIDA FLORIDA
STATE OF F
� �I P
LOF _ST;LQME
COUJVT Of ;V:LQQIE
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowle�dged before me
this 610 day of -G/ &C1 S%, 20 Iby,
this Q-�o day of }^u G--K z 7 .20 c90 iby
INIATTHEWiUY1 i;LE"NNE
iMATT11H,Ew;VUE1wYNNE
(Name of person acknowledging)
(Name of person acknowledging)
c'G-•
(Signature of Nota ublic-State bf Florida)
(Signature of Nota blic- State of Florida )
Personally Known X OR Produced Identification
Personally Known X OR Produced Identification
Type of Identification Produced
Type of Identification Produced
Commission No.. = "•• DOROT0ARNBASKIN
•.•;
Commission No.
DOROTH AVYASKIN.
;; MY COMMISSION # GG 030145
MY COMMISSION # GG 030145
Rv S9i 07/1:�/_
� f�tRa`� Bonded Thrti Notary Public UnderMters
EXPIRE
��'' • �y� BOnCed ThN Note Public Underwriters
`(;;•• Notary
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW.
REVIEW
DATE
COM PaAf.TIE .
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