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HomeMy WebLinkAboutBuilding Permit Application Ali APPLICABLE; NFC)MUST BE COMPLETED-FORAPPLIOWN TO BE ACCEPTED:
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PE>{MIT ARPLfCAT1ON Ft fi. ( , h�l .
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' Address. � y a. m. t S - i
Property Tax lD#:_ � ©� [:ot No
Situ P1arti Nam '
Bfock No: _
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Ne�'Electrical Meter "I Second-Electc"real Meter (Affidavit required]
F "� � :
Ad-clitionat,w kt 'be performed ran er this: _erm t-cHeck ail p . ..that apply:
Mechanicaf' Gas Tertk .._ .Gas Piping. _Shutters VI%indow"s/Doors Pond
!Electric YPIurnjl ing _.Sprinklers GeneratorFitch
Total Sq Ft of Construction
Sq..Ft..of First Floor...* 1124
Coast of ConstrWion ;$10 O(bo
- _.. Utd�tiesSQwereptic: Building Height:
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Zi Code• 3ak' Fax:
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Phone city + 1 .: State
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Mail:
E Zip Cdeo (F'�� fax•
nd I r IW
mCctSf Phone No 3J
Fil(irt feesimpte Title Wofder orr rte
xt page'(if different E=tNaii i`Y1.kl t Y �tic�:1 'S l`T i��t f "m
fromahe:Owner.listed above?
1c 5t..� State;-or County license
Ifvalue of construction isZ500 or more;a RECORREC?Notice of Commencement:�s,requiired
ff value of HAVC:is$?500 or more;a RECQttDED Nonce af.'Comtrrehcemeitt is required.
aEsrGNER
-/ENG1lV ER�F E `licabi.
Name;
t Applicable, MORTGAGE..CMPANY. Not App..
Andre Name A
1.ss;' " Address.
State= :'City St;rte, ..
Zrp , Phone
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FE.E„ t�U M,jT�E H©lDER.: ;Not App
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3: : OWNER �ONTRACTQR AFF[DVIT.Appltcat�on Is;�ereby made to cbta�n a permit to do th,, and(rrstaitatron a"s indicated,
1 certfjr thatrta work ar instaltat�or has commenced pnorto the�ssuanteof a permit; -
St:;Lucie Coun makes=not r "' tibnthat;is"rantin a ermrt';w�il authorize the,�ermrt holder°td build the sibject:structure'
tY ap.esenta p
v�rhlch'„confllctslivable Homeowners Association riries�,�aytaWS or and covenants that,iri�Y restrict°ar;prohibit:;such.
strvctu fie_ t'teasecorisutwth your,Homeowners�►ssoeiation and i eview;yourdeed for any restrIcE�ons which rgray app Y�.
in for in accor�ddearnactei with the pproved pl , that f Will;jn ali redsmpeentst,s,0,00 t?e'woc
on of the a tmg of m greeCumnanstheEbd8wldingGodes andSt Luceo ts
The fiollowin building permit appllcatjons'are exempt from undergoing a futkonturrency revrew room additions,
accessory„struchire ,swirn:ning pouts,fences,uvalls,signs,:screenroomsand accessory uses to artather:non resrdential'use; '
WQRNING'TU OWNER:Your failure#o Record a Notice af'Cc�mrrrancement may result m payingtwce for
improvements to your property;A Notrce;ofCorrimencement mush be;reuirded rn:the pubUc records of St:
lucre Gou n osted n thR jobsrte before the Jett ir_5Pection_ if ou intend to obtain financrrrg,Consult ;
At sari r o : ,;. ' before commencen work ar recordiri . ourN0 JCe.of_Cr mmencement
Signtur ,of Ow 5r seej ontractor,,as Agent far Owner:
STATE iJRtDA...,.
C'QUNTY'QF �n,.5; n�
Ph sicaiPresence ar Online Notarization;
Swag t or affirmed air subs_robed before me of Y ,
this< daSaf ? bY-
Na»e of= . rsan,mak�n�;statement _ . .
Personally°<Knawn �OR Produced'tden 1f bt�on
pe of rdentdic ton P ced
rodu
(Signs_ re of Pratary Puril.ic State o iordat
MITAICIA ANN CHACON
issioRNo. •tSealj; �.. s `My C0r4hiy5i0N#GG367d74
.Corinrr!.._ _. - �• 4z - EY,F'IFtEB Augt�s,�°1,�023;_-
"��R e•�� .'ansrCd Tiini lVohaY PulAC Unddrwt tets.
-- . ....
REVIE1t5 FRONT- 20NING: SUPERVISOR PLAINS NEGETAT.10111 SEATURTLE MANGRf?VE
COUNTER w I:V,IEUV �REUft `REVIEIIII REVIEW REVfE1N: REV1EUtif;
D,"A7E
3
DATE..
COMPLETED ;