HomeMy WebLinkAboutHoffman Placita ct permit appA LL
,4PPL I CAB LF 1 N EO MU ST DE CO M PLETFo r 0 R APpLj(:ATI0 N -vo RE ACCEPT E D
` Permit Number;
Date: 2
i
J 731
-
BuiMding Permit Application
Pr.0nIII irig aria DeVEIOPment5ervice5
nuitdrriI arid Cody Regul 't" Divis'On
2300 Virgin io A venut,, For- Pierce FL 3 A�-1��8 Co m rn a rC I d l Re S I d e rit i a ll
Ph -one. (772) 462-1553 Fax: (172
PERMIT APPLIC AT1 11 FOR'. T i t ffom d ropbo , cli-I arrow at the end of lane
PROPOSED MAPROVEMENT LOCA
AddrIIIIIti
legal Description: .. . ........
� � y Lot No
Proper-ty Tax ID M block No.
ite Pl-an Name=
PFoje-.t NaMe: {
ett}a (; k 5 Front —
Back,, _ � fight Sidi; � Left Side'
DETAILED DESCRIPTION OF WORK: ,
SVI' r ifoor
� ,
� � �I
�A-.k
FA
INFORMATION:
itiona I %,j 6 rk X -6 erTorrrre un « er t p6rr5it — ef a
0 HVAC Gas Tank [IG a s Pipirts
11 Electric Ll Plumbing OSPrinklers
app
L_.� Shutters
DGenerator
T0131 Sq. I=t of construction; 5 Ft, of First Fl
o -or,
Utillti-eS= Surer P1ic
CI of Construction: , -
i OWNER/LEEF:
Nara
Address: —
city, Start ;
zip Code, Fax:
Phone ND.
-e LIE
E-Mail- iZvI`4 i--a3L— -r �0
Fill in fee sirnpla Title Holder on next page j if different
CONTRACTOR:
Na rT1E!:
Company
Address:
zip Code; _ Fay.
F) Win�lows/Doors
ORGof ti RQ0f pitch
Building Height- �
Phone ft.
E-flail: J
frarn th-e Owner listed above) State or County License:
If value of construiI i!G �2500 or more+ a RECIORDED Motita of Commencement is required.
SUPPLEMENTAL CON TRU T1.011 LIEN LAW INFORMATION.
DESIGNERIENGINEER;
Not Applicable
Name-
Address. -
City, State:
zip: Phone
FEE SIMPLE TITLE ]HOLDER: VrNot Applicable
Name.
Address --
MORTGAGE COMPANY.- Not Applicable �
Name;
Address:
City: State:
Zip: Phone:
BONDING COMPANY; Aot Applicable
Name:
Address-
City, City:
Zip; Phone; _ Zip-, Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as Indicated.
I certify th.a t no wo rk o r i nsta I I ation h a s com m ence d pri or to the i ssua n ce of a p erm it.
St, Lucie Co u n ty makes no representation that is granting a }permit will authorize tyre permit holder to build the subject structure
which is in conflict with any applicable Horne owners AssDciatian rtrle5, bylaws or and coven' ants that may re&16ct -Dr prohik31t �LICI7
structure_ Please oonsuit with your Komi Owners Association and review your deed for any restrictions which may appIy_
In consideration of the granting of this feq u Psted permit. I do hereby agree that I will, ire a II res p e ets, perform the work
In accordance with the approved plans, the Florida Building Codes and St_ Lucie CQuntyAmendmonts,
The following building permit applicatiuns are exempt frorn undergoing a full eoncurrenc-y review: room additions,
A ccesso ry stru cture5, s wi mm i ng pools, fen cis, wa Irs, signs. s Cre e n roo ms and access o ry Ll Se 5 to another n on -res i d e nVa I u Se
WARNING TO OWNER: Yoiur failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Comrni�neernent must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consuft with lender or are attorney before
cornmen cinz w9rk or recording our Notice of Cornrr,encernent_ �
�i gna t u r e of 0'Wn er f LE! Se e/Cdn tra cto r as Age nt fo r Own er
STATE OF FLORIDA
COUNTY OF sllr L� 1
The forgoing instrument was acknowledged before me
t h i day of 20_d I by
Name of pZ
making sta tement
Pers❑nr3lly 10NO ern OR Producscl Identifir.�;tion
Type of Identlfrcation --
Prod-uted
f 5 ign ature of N DU ry Public- State of Florida )
Commission No, Seal)
1 R EVI Ews
I)ATE
RECEIVED
DATE
COMPLETED
Rev, S12/17
Ndls1' of FWda
T/gl l V •ram V
1d
t.IJI! �
FRONT N�COUNTER�fE
Sig n dtu re of cinf r� ctorf Li re
e -Holder
STATE OF F LO R� A �j
COUNTY OF_
The forgoing i n stru m ent wa s a r kn owl edged bef ore m e
this 2L day of _ '�r'1� r 2n bar
Name of pers ,,faking statement
PersonaIIy Knov r� =0R prod u-ced I'denofcation
Type of IdentifGcation
Produced
ign atu rg! of Notary P u
mmiSsion No-
WkANS VELETA J
REVIEW REVIEW
- Stow of Florida)
Notary Pvbll-c 5 A cf lob' a
Deena M ;Sabeile
W;r My CEIMM13ticn GG 22!r7VG
PY IFS! Off: i J J Plii
REVIEW I REVIEW
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