HomeMy WebLinkAboutpermitAlf APPUCA ALE INFO MUST BE COMPLETED FOR APRUCATION TO BE ACCEPTED
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Perrrrit N21m Ear!
OuildIng permit AppIication
:3url�rng 4rrr Qd� f��quror rr Commercial-- Residential
2300 Vjegir?,o Avenuc, Fat fierce FL 3&992
PChonc= (772) 45?-1553 Fax_ [T72) 462-1578
PERMIT APPLICATJON FAR:
PFUDPOSED I MPRGVE ME NT LOCAn ON: __..
Proper tyTax ID#; 4,D'� Lot No -
Site Plan lame:
'Project Namc:
D ETAI LED DESCRI PTI ON OF WO R K
a
New Efectdcal Meter k-cond Electrical Meter
-
LC 9I1 FRoATlll:— —
Ad&tiornd work to be performer under this peffnit - check ail that applT.
Muck NG_
—median, kal _ Gras Tank _ Gia� Pipi nF, _ Shutters � WrKd Y s/boor s _ Pand
Electric _ Plumbing Sprinklers Generator Rlovf Pitclh
Taal Sq. Ft of Construction;
Cam� # of Coruction; � c) ?
OWNERA- SEE:
Sq- PL of FIrn fd ;
ubyitie. _Sewer _ Seprtic Bu i.lding Hei&rz:
Address: Lyef - LR.
lv-�
Zip Co&: — IF-=
PhorrL�- No_ 2 L 2- J 'f 3 Of-
Fil in fee SiFF Tide HQ1deF on nod page( if different
#rarn the Amer grmd ahovi4
CONTRACTOR:
l+lame:_ .--,)
Company: Aw-m-L-
Address; 'N i S AE:5-54-
cpty- —. P•-" c
State:
Grp Coder y4 Fax;
A11A
F hom No v216 —
Sep _
State or County L3certse - 3 l ! 7
If V*lu-eof wristruaiarn is 25.00OF M&M, a RE.00RDE;E) Natke of ComTTjerrccmeFrt is regLLbvd_
H h+21ue of RAW i* $7,500 -9r rMre, a FCECOR1)ED Notice of CULtl&A-m&smmt i% reqLrkrxj,
. L} PLEMENTAL CONSTRUCTION UEN LAW INrORMATION:
EER: _ Not Appka bl e
Name:
Addre:!Rs_ --
City: State:
Zi P; Morw
s FEE 5I1011g4� T1T1 E HOLDER, _ Not App!--Cca!?lc
Narne=--
I Address_ -
City:
Zi p' P1 ror:e:
MORT AGE MPANY;
Not AppJica bie
Name;
Address:
City+, --- - State:
Zi p- Rhone:
RONDJ NG COMPANY: �N Qt Appl i cable
Name:_
Ad&rc .:
City:
Zip:
Phone: _
OWNER/ CONIC OR AFFIDVIT: Application is hereby made to obtain a permit to do d by wprk and irrstallafign as indicated_
1 c-erdfy that. 310 ,rrl5rk ur in%tA1w jipn bas comm cnccd prior to the issuance of a permit
St- Lucie 03LML r Teak&s ni� r(Lpri-enl4wo iflat is? andirlF a perrnit will authWiDe th hermit bolder to &AM the suh�d structur-
vehich rs in kit w€tFr arrg a ppkable Home chvrws Ass�a#ion ruke , "awtx or pr.d �,�n ,. that may restrict or prohibit such
structure_ (lease consult wfth +dour Homy i}wW& A j;pti �m ;end mmrw yvur deed For any reSt k c ns whkh may appLy.
In imrlsrdti8tinn 01 thi.- rrznkinF, of this requested permit, 3 do hereby agme ttrat I will, in Al re t�, pc-rtvrrn the. yr�
do Nuordiume with the apprwo--d plans, the Florida Building Ccdew5 and St. L uKv.- Qaimty Armcmdments.
The foPuwing builiding permit appl iutions ar-P "erMpt fri)m LXndcrp-urnp,a Full ivT+.curTenoy reVRw: roars additions,
acre Wry 9 t i uH:!vr4-�, ywermminp, pools, fence, walls} skns, screen rooms an d au��s :r}r uses to arbour r.p" L!ntiuI +asc
WARNING TO OWNER: Your failure W Record a Notice of CornnlencenwbM may result in pa*ng twine fr r
imp rove m4! rits to your grope rt , A Nclice of �arnrnerrce merit m ust be recorded in the pu blic records of St_
L vrie County and posted on the jobsi to before the fiir�t irr-spWion. It you intend to obta i n fi nafti rig, Wnsuf t
with letuler or an attpLi eyb-_i=ore commen6ing work -or recording our Noti❑e of Commencement.
r�
Signatu 7wh 4-4;5 t Factor as Agent for Cwri�rr yja�natrrr pfQ _ wenw Holder
STATE 04-' FLI DA $TA
Sworn (ar affirmed) and subm ihed before m� (3t Sworr�� (4r a#firTned? and subscribed before me of
Phi oa I Pry W Online Notarization F$ sjcsl Pfes Oe or _ Onlinc Nota riaatio n
thL% � ayr of � , - 2 by#hid ( yr a'eA- 2020 by
€ 6 L �
i1*rnc` 04 peryun making Amement. Name of peri6i making stammi-wt_
P*r9o"lv Known LOR Produced Identifiution Personally Known OR Produced 1d{-ntifio!brusa _
Type c F Iden fifcation TV g1 Kent1 fiu4twn
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REVIEWS FRONT ZONING
SUPERVISOR PLANS
VEGETATION
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COUNTER 'REVLFW
REVIEW REVIEW
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REVIEW REVIEW
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