HomeMy WebLinkAboutBuilding Permit Application41, f' 1,1949V 1FIF9 Duff ff 99WPUP F99 lippfI6ATION T9 99 AMPT91?
Date: R� � T �, '01 Per Nurnber: -
13milding Permit Application
Planing end 90pingmnnt fiervion ...
WIding and 90#0 Regn100901viVAP
9199 Viglnig hvennol fort Pipw ft 009
Phone: (772) 4624553 Fax: (772) 462-1578 Commercial Residential: X
PERMIT.APP�JgATION .FOR:
PROPOSEiP�R`OVEME'NT LOCATION:
Address: R—RA1A1=NO
Legal Description:. @TI01�_9N /-TI@� N&41lR 9@9 / RA1`4@9 40# .
Property Tax ID #A414401.17911 A9M Lot. No,.
Site Plan Name:- §RtAN& 6t$Kg§ @N Block No.
Project Name:
Setbacks r . r .:Front§ _ Back: 921rr i Right Side: JHri Left Side:: )
r rr
DE TAILED,DESCRIPTION OF WORK:
.... .. ....
CONSTRUCTION INFORMATION: u.
Additional wor .to a nertormed. un er t .is permit. --check. a apply:
HVAC ._. LJ Gas Tank Gas Piping Shutters a Windows/Do.ors... El
®_ Electric Plumbing �Sprinklers Generator_ Roof.
Total So. Ft of Construction. S . Ft: of:First:Floor: `Ir
Cost of Construction:: $ :11',9�4:�Q Utilities:Sewert-leptic Building Height:.
OWN ER/LESSEE:
CONTRACTOR:
N a m e W NK.PIS PIN PQORP ..
Name:_ PRIP �� k W
-Company:' . � K ���Y����F�I�I�I�T �9�1�: .
Address: POP NYT-0 W§ Hif ) : WIff 429
City P@RT I` T k� I State: R
Address..NPQ �Q04 W II ` �T � .
Zip Code: MUFax () §71
City:'@T.Tr.II^ State: Fk .
Phone No: f77 ).�7OP
Zip Code: ' 2409- Fax: V70 �M-706
E-Mail:.
Ph0ne:NoA779) §7§T§§ :
FIlln.f §J0pJ@.fJWH&OFon.ri'Ie#mgo. if iff r�nf.
E-Mail: :
frpm fhe PWnq'`Ifted @bAJ@)
State or County License: II
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SUPPLEMENTAL CONSTRUCTION LIEN LAW_ INFORMATION:.
DESIGNER/ENGINEER: X Not Applicable
MORTGAGE COMPANY: x .Not Applicable
Name:.s"rr:ve-woobs
.
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone: (772)618-66"
Zip: Phone:
FEE.SIMPLE.TITLE HOLDER:. x- Not Applicable
BONDING COMPANY:. X_Not Applicable
Name:
Name:
Address:.
Address:
City:
City:
Zip: Phone:
Zip: Phone:
I certify that no work or installation'has commenced prior to the issuance.of a permit..
'St. Lucie Countyy makes_ no representation that is granting a permit wi,ll:authorize:the permit'holder build the subjectrstructure
which is in conflict with any applicable Horne 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
in 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 OWNER: Your failure to Record a Notice of Commencement may result in your_pay"ing 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 re -to your Notice Of Commencement..
s
_ Signature of Owner/ Lessee/Agent C Signature of Contractor/Licen a Holder I
STATE OF FLORIDA STATE OF FLORIDA,
COUNTY OF ST>-;, �, E COUNTY OF gr i(-u u e
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of /llo u(%� /S�t, 20 Roby this day of /1f!ad edyL 20 Eby
'I t r S�cE �itJ yNN & R-,C .
(Name of person acknowledging) (Name of person acknowledging)
(Signature of N Pub/lic- State of Florida) (Signature of Nota ublic- State of Florida )
Personally Known -toe OR Produced Identification Personally Known 1z OR Produced Identification
Type of Identification Produced Type of Identif'
tY?i D.OROTHYANN BASKIN
Commission N .''<!pYP y DOROTHYAN(S�AS/(IN Commission N ` "_ COMMISSION 3
4 :*; MY.COMMISSION#HH04W3 EXPIRES:October2
:d' EXPIRES: r 2 `'•'F�F F��:' Bonded Thru Notary Public Underwriters
.;o'F F,', • Banded Rini Nowy Paw Underwriters
)!Revised 07
REVIEWS _
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER.-
REVIEW
REVIEW
REVIEW
"REVIEW
REVIEW
REVIEW.: .
DATE
COMPLETE
INITIALS .