HomeMy WebLinkAboutBuilding Permit ApplicationALLAPPLICABLE INFO MUST 09 COMPLETED FOR APPLICATION TO BEACCEPTED
Date: p Permit Number:
Building Permit. -Application
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2300 Virqjn10 Avgnyg, Fort P10mg FL 34982
Phone: (772) 462--1553 - Fax: (772) 462-1578 .:Comirnerdal RetidentiOl X- . . . . . . . . . . . . . . . . . . . . . . .
PERMIT APPLICATION FOR:: p
11ding
PROPOSE[ _JMPjR,,OVEMENT LOCATION:
Add ress: � 61 IPAN9MA- WAY.,
Legal Description:. E-AU-1/2 OF $ECTION, 1: TOWN6HIP 346- RANGE 3915
Property Tax ID Lot No.
Site Plan Name: -99UNTRY MID VILLAOEE Block No.
Project Name:
Setbacks Front. Back: Right Side:.. Left Sider
D E"t, AILED b8CRIPTIONO F; WORK.*
51NOLE. FAMILY: REOIDENCE (ropla0mont: home) - - 3 BEDROOM r 2 BATH$ � I 1/2-CARAGES
NO $LAD WILL BE -BUILT OFF REAR OF -HOME
CONSTRUCTION INFORMATION:
Additional-worK to 15--- rtormeFd- under this --per mit- --ch eck.all: app !y:
0oo
. . .
HVAC Gas T Windows/Doors.
Gas
Tank . Shutters.
Electric Plumbing Sprinklers Generator Roof.
Total Sq. Ft of Construction: 9- 494 q.
S Ft. of:First: Floor
Cost of Construction: $ AM Utilities:. []SewerE]Septic Building Height:
OW`Ntk/USStIE:
'CONTRACTOR:
Name N @k&PlN9'P9PMfM9 --- HT
MATT-I!9WVL9WYNN9.
Address: 69@0 9OWTH UP. HWr 1.z'f?9JTEz 4@2
Company: WYNNF VF__LPff9PM9NT:0QRPQRAT1lQN
City: PORT 6T., =119- estate; R
Address. 6000 $PUTH U9 HVVY, I PUITE492:
ZipCode:,04959 -Fax: (772) 676r7@0
city:- PORT 6T, LVO19 State: -FL
—
Phone.No.-_(772)-@7@r§§1 0
Zip Code.:. 04952 Fax: (772) 7650
E-Mail:
Phone:No. 17-72)
lill 106
E-Mail:
from the Qwn@r li§tgd abow)
State or County License: 00096-
it vallso ®f 69owyalon if �Zpqy or Moroi a wphPlEEP NotJ99 Of 99MM@n&@M0nt I§ geqUirgia"
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE.COMPAW _ Not Applicable .
Name: B}34oFN88RAOtN
Name:
Ad d ress: 417 COCONUT AVE.
Address:
City:. STUART- State: R
City: State:
Zip: 34996 Phone: c7723287-825e
Zip: Phone:.
FEE.SIMPLE.TITLE HOLDER: = Not Applicable
BONDING COMPANY: 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 ofa permit.
St: Lucie County 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 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: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 recolding your Notice of Commencement.
_ Signature of Owner/ Lessee/Agent Signature of Contractor/License Holder.
STATE OF FLORIDA STATE OF FLORIDA.
COUNTY OFS' T-. k,%4 c i e' COUNTY OF: 5-r . l..ia c, 4
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 9'6 day of (0 ex-p r% &—fL 20 2eby this 418 day of O c-m.6 eW . 20 90 by
(Name of person acknowledging) (Name of person. acknowledging)
(Signature of Notd Public- State of Florida) (Signature of No Public- State of Florida )
Personally Known ✓ OR Produced Identification Personally Known ✓ OR Produced Identification
Type of Identification Produced Type of Identification Produced .
..
Commission No. "':P DOROTHX NIMSEN Commission No. :°«'"� ''. DOROTHYA"i9Ab%NN
*; * MY COMMISSION # HH ,, MY COMMISSION# HN 04M$RES: October2, °; c`,: EXPIRES: October 2 2024BondedThruNotayPubllcUnr8 ••.,o� ��,,,• Bonded firu Notary Public Undertvr�kers .
Revised 07/1
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