HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONF�)
LE INFO MYSi BE COMPLFFEO FOP APPpU90N i0 aE ACCFPiEO
Date 'IInZI vermin Number
CLL -
IBuilding Permit Application accCommercial Residential Avmuy Port Pkrte fI MM
Ia6b1553 fax:f222)a62-1S28
PPLICATION FOR: Pr0h l�%12`I�IGF rn�1 UD
Actual —V)Z 5 M061 Ave R-P rrCe FI 3LK1Sa
PmpertyTa.lo r: 2434. IOA1-DDLI, Og0.5 Lot No. ..
Site Plan Name: Work No.
New neMOl Meter SecondfleRnul Meer
Additional work to be performed under tbl¢permit- check all that apply'.
_Mechanical _Gasiank _Gas Piping _Shmers Windows/Non _Pond
_Electric _Plumbing _Sprinklers _Generator _Reef _Pitch
Tool Sq. If of Construction: SO Ft Of FiM Flom:
Costof Nnstructlom5 T054 CCa utilities: _Sewer _septic Building Neighc
zip code: _2QR2 Fax:
Phone No. T2 41 F F�
IIIFIII In fee simple Troe Holder on next page ( if different
form the Owner listed above)
If value of mnchumon Is 25W or more, a XetYxutu Noave
If value of HAVE is 4,500 or more, a RECORDED Notice of Cor
ndnreu. Name: ml aa:
City On.
LP: Plane: ZIP: Ppon¢:_
el apt no xwF orinAallalbn M1asmmmenaap,i for ppswan[erol to chief, 3 Name to dot" nark and installation Ill aboard
.
MMr�m play ft.
wrb¢[ieaiconp akes no mthanyapplireabte Nome Ownes t4ualalion mleaabYlaosxe mt�emenanrfdtpetmgrnplrlttnrrtpMippsu[p
s sure�Pleasecnsultoom vow Nome owns. Auxlatin, tine,mewya.8nd anvrenrkawns"khmavaP
In in accordance Consultant, l the parbiq of thus requested herself.l da hereby, agree that l will, in torsions, perform the swri
will
tM1Me approrttl plan; the annular auddingfu@s and sL Wd,raanry PmeMmems
The following madiag name appliances are erempt from undergoing a lull ccnwrre icirtvi m mom addoon;
ssory stm[Wre; mmming pool;knee;wall; igmsr¢m momsantl Kmss uses to another nonresidential use
WARNING TO OWNER: Your OHIOhe to Reasons a Notice of f mmmament may resuk In paying!vane for
improvements to your property. A Notice of Cammencement must be retarded in the public records of St.
Lucie [Ounry and posted on the jobsite before the at inspection. If you intend to obtain financing, consult
with le�nderoan attorney before Commencing work or reconir our Notices of Commencement.
$NNtuhe MOwner/Lgeaxe/tomrachor as Pgem for Owner
Slgmmreof (mbatter/licenuxd r
ATE OF FLORID
am Lucie
STATE RIDAgi
COUNry
COUNIYOF
OF Al 4J6e
swoyl Ion aMamedl�anRd subssrlbed before me of
v
Swoq toles axiam<JJdl and wbsnned Mae me of
11�y�iol Prexpgp Online National
t J�N�
PpgiUl Pr<smce Onrme Notarisation
is Lb dayof Zoxo by
TM1�s�tlay of '�50� Zalo by
Conn:c 6rRCo
Connie GrHce-
Name Of peranin m,ulg statement
Name of person makingretained.
Personally ynown ✓ OR Preduretl Identification_
presontly MnaM —ii/— OR Produced mmafiWaon_
Type of Mummification
T�Ipf llddenNnWem
Produced
pry/
II
lslgn ureol xoTary PUNS -site REFLorIda fa+Raywra
lslgn,Ture Ofxaary Puxk-stain dflrtla fatvgtrgw
f `a
,�a a
Canmiulan No, NmaO/�l • ' =MtM;a
om
Cpmmlsslon No. 067 ; ayynP t
w r wwwM<laew
Mlmr
REVIEWS FRONT
ZONING
SUPERVISOR
r P.N.
VEGETATION
SEATURTLE MANGROVE
COUNTER
REVIEW
RENEW
REVIEW
I REVIEW
REVIEW REVIEW
TE
QNEO
FTFO