HomeMy WebLinkAbout200 NE Solida Permit App (1)All AI'MICA111 t INI O Kit P,I ItI t 0N11•I1 11 t) 10It AI'I'I R AI ION til lit At( I 'rl 1)
` Building Permit Application
Pr�nrnit;rrttr fie'veH,�lnrdvlt lcrvrrr'+
Alrrkri..,,idCodrRevulormn Vmskm I. tllllll►t'il 1.11 1t1^.IdeIIII.II
+ ,- oki AvmLw Fort Pkrry ft 14W.
, ' 72� 4t,,' ISS3 I :tt (771) 40 110,11
I'l t-All I AITI It Al ION 1 sal% N't, I;,,,,I
r
PROPO_&D IMPROVEMt NI I Ot Al ION
111kiti11'" ',h1 NI ',r,lid,t 0i I'imI ',I I m ie, I l
}'(nperty 1,1x Ill tl 1 11 `l ,1, , 111l i i 111111 ', I r rl Nei
Ni�1 lilno k N,r
Site Plan Name
PfojeaCt Name =") Ni ',oli11.1 Ill 1'1111 '_d I u[ 11% 1 1
O TAII ED DESCRIPTION OF WOO T.
%M, t-'di tell „tt 0w oI-Jpnl .r• I+h,111 .hlfylle 11111 crown 11i Ihr' wnrnl do' I, 11111 n,nl 1111 rho dol I. lei 111r. r wr, ui , iulr
In�tRll ;1'.e�i} ,trlh�••.r�r I11 ullcir�ll•1y1n1�tttwith n .'1,�1.1 3,V nu'4+e1 luufngl �,y•,I,�n1
Now Ilet lrr,.11 Metot Nrrl ti,yrrtrli1Irrlru.11 Mrt,rN1A
CONSTRUCTION INI'011MATION.
Additional work to be performed under this pt rn►tl — Owt k Al 111.it ,1pply
—Mechanical — Gas Tank e Gas piping _ Shutters Windows/Door.
Electric Plumbing Sprinklers —Generator
Total Sq. Ft of Construction: 270a __ Sq. Ft. of first I.loot, N/A
Cost of Construction: $ 13.815,00 11111i1ie Sower _„ 1wpirr
OWNER/LESSEE:
CONTRACTOR:
Natne Elizabeth K-10ol
Wim, ' Im J,ililwi r nlirrr,
Address: 200 NF:_Sollei,l I11
Conrp.my c allot, i;ncrhrul I110
City: Port St. I [wil I I St,11C: r,
Address, I,(' Hog 1.111.1
Zip Code: 34983 1.1x
Clly I url I'1r ri r
Phone No.228"V90"0332
tip Code: l'I' 1 i`I I .,x rj//\
E-Mall: ECBIENK02OGMAIL t c1M
Ph,rn1, Nn ii."11u ills)/
Fill In fee simple Title Holder on next page( if diffewrit
I M."I c,111i1r.1iurllnclnlr i l3rlltl.lil r rrn
from the Owner listed above)
'A.itr- or County Llcam,e• ` 1 ' c ,dW I I
if value of construction Is 250e or more, a 14CCORDED Notice of Comrru ncement Is required
H value of HAVC Is $7,500 or more, a RECORDED Notices of Commencer„r rit Is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNE
Name:_
Address:
City:
Zip:
GINEER: X Not Applicable
Pho
State
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY
Name:
Address:
Citv:
Zip: Phone:
x Not Applicable
State -
BONDING COMPANY: x Not Applicable
Name:_
Address:
City:_
Zip:
Phone:
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.
St. Lucie Counter 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 buildin it applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimmi�0N&'feK wails, signs, screen rooms and acces uses to a t tial use
WARNIKIG TO OWINEft: Y ur fallure to Re rd a Notice of Comm ement may r t I paying twice f
provement4 to yo r property. N ice of Commenc ent must be c rd in the public r cords of St.
Lucie Cou>►tx d p ted on t s e before the firs inspection. If a ..to obtain an ng, consult
with [end€ ornev ore mmencine wor or recor�ine v t" of Corer e nt.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
/
�`(1 �FLORIDA
COUNTY OF )
i
e— ([
COUNTY OFt 0-4
SW to (or affirmed) and subscribed before me of
Y✓ Ph Presence Online Notarization
Swor to (or affirmed) and subscribed before me of
=Physical Prese Online
sical or
this,B day of 2020 by
ce or Notarization
this day of 2020 by
%nl Ufas
ns ob /1J, -
Name of person making s atement.
Name of person making statement.
1/
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Prod d
Produced
19-
(Signature il4u ,otary-Publi State of Flpr ' h[ "
b- Slate of Florklo
(Signature of otary Public- tate Af loridt y r
/ sa'
Canmrsn A GG 167258
Commission No. My(98WT%PmDec 11,2R[1
Commission No, 7Zt, (Seal)
a�rd�d�n�,pwsurn��
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
MREVIEW
RECEIVED
DATE
COMPLETED
nev. 7/ a/ IV