HomeMy WebLinkAboutBuilding permit appAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO U ACCEPTcO
Date., p4�i lit Nurnlboi i , _ — --l-11 1- -11. 11-1-
161
J. Building Permit Application
PJanniny and
uuildinq and Code Requidthm, CI Commerclal Residential
"00 Wra, imQi A ve, ae, Fort Pit! i j�- e 982'
Plfione: (7721 462--ISS3 fax: (1721 4f 15-18
P[-','R,MITAPPJJCATl0NF0R
PROPOSE".) RvIPROVUOUNT LOCATIOW
Propwy Tax it LZ 5 Lot" No-L-U"-I---,
Site Plan Name, Stock No.
Project Nerve- --- ----------
DETAILED DESCRIPTION OF WOM
4 t )ZA ar '
Additionahoiorktobeperf rMed under this permil -Chec, at'1 I ppty�
—Mechanicai Gas Tank Ga% Piping Windows/Dours Pond
Electric Plumbing Sprinklers Generator Roof PRA,
LQ
"otal sq, Vt of constrilction, J loor:
F
r Septc Building Heig-,-W
Cost of U
CON MACTOR:
Name
2
Address: Comparty" V -01 —06)
JEQV,� _U
City., JP affijbv-
state: Address;
City: zc, L State:
Fax:
ap Cade�
CA --
Phone No, ip C,
�z Ode: i--ax:
Phone No=-iuL-,�z�-
kol L
Fill in fee simple Title Holder on next page (if Siff erenEM
t -ai ��
i fromwner listed abovstateor Coumt�,
E.
if value of cnilstruction is 2SUo or mare, a RECORDED Natict, of Commencement is requima,
if, value of HAVC is 7,SW or more, a RECORDED Notice of COnIt',lentcmefIt is f044uitcd
Not
Name:
Address:
City: State:
Zip. Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY:
Not Applicable
Name:
Address:
City: State:
Zip: Phone: i
BONDING COMPANY: __NotApplicable
Name:
Address:
City:. f
Zip: Phone: I
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance, of a permit r
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 Assaaation rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consultwrth.your Home Owners Association and reviewyout 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 j
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 irt, paying twice for
improvements to your property. A -Notice of Commencement must be recorded in the public records of St._
Lucie'County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
.,:wit i .., ak—fr ,-.,.,,MC%nr-inrr Munro nr rprnrriina vniir Nntire of Commencement.
er Lessee/Contractor as Agent for Owner
Si ractor/License Holder .
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF ✓ -
Sworto (or affirmed} and subscribed before me of
Swgm to (or affirmed] and subscribed before me of
Notarization
Physical Presence or Online Notarization
Physical Presence or Online
thi'-=L dby of 201 by
this 2l day of C"1�1! °. A a • ZO Z_j_ by
3
lI�JG.r L l lJ ��1
J JrLY —C L �S
Name of person making statement
Name of person making statement.
Known /OR Produced Identification
f
Personally Known OR Produced Identification
Personally
Type of Identification
Type of Identification
Produc dd
Produced
1
(Signature of Notary Public-
y a�8.., ASSANDRA M VOLAGE
ignature of Notary Public-S # o p a CAssANORa M
OLAG
Notary Public State of Florid
1 ( ��� L '. `� m : % S
Commission No. �: (i�missior GG 923210
Notary Public- Stat
('i(9 "" mmission # G
OmmisSion No. '� Z li ;"Seal
c
of F I
9232
My Comm. Expires Oct 16, 202
'?o.F�°• My emm. Expires
Bonded through National
ct 16,
qotary
Bonced throuflh National Notary Ass;
.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
�'
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
{
DATE
COMPLETED
Kev. 5/0/ 4v