HomeMy WebLinkAboutBuilding permit appAII APPUCAAE I FIO MUST BE CO PI.EIED FOR APPI-rcANOT TO BE ACCEP?ED
Date:
Sr: Luelu -"r
I4trffiFffi:Building Permit Application
Planning ond t)€veloprncnt *rvices
Bt ild/ng oNW Regui/,i'iol/. Divisi.n
23U) Weinlo A/€nu", Fon Pierce FL 4982
Phone: (22) 452-1553 Fax: (772) t[62-1578
Commercial X Residential
PERMITAPPUCATION FOR:
IMPfiOVEMENT IOCATION:
lddress: QlrSb 8ou,t1.t g,-o,l \c , l.l*tchinsen Esload FL 3,19 L-t
pmperty Tax rD ft t{Sba- Lro-oooo- Ocp/ (r'
Pmject Name:AoPoorE a (ec.b\nels)
OETAILED DESCRIPTION OF WORK:
Exiq*inq T:fnop'-i\e. ba lterv ca6,ncl a.nA S,lr< s,u)oc,r f eab', oc,-t lo Lrc rzn,o,rcl ,J T
Inslal\,n (r Ltaosi+<.0
New Ehctrical Meter Second Electrical Meter (Affidavit required)
Additional work to be perbrmed under this pemit - check allthat apply:
_Mechanical _6as Tank _ Gas Pipirts _ Shutters _ Windows/Doors Pond
PitchI er.art _ Plumbing _ Spdnklers _ Generator _ Roof
TotalSq . Ft of construction: Elittlaq 5q . Ft. of f irst Floor: NAJ
Cost of Constructbn: S 'rc Utilities:_ Sewer _Septic BuildingHeight:llt'
lf vahe of co*stnction b 25{Xl or rnoll, a REq)RDED o0e of Commeacemem is rcqlired.
tf uelue ot t{Alrc E SZSm or nrr., . nEoORDEO oale of Commerlcc.n! rr b Equtred.
Phone l{o. g 13-t 45.? -
State: R-
E-
Name T-rnDb;ra
City : T-arn oa-
q4q7
zig
lddress:5iOl
code:33L3{ Fax:
Addrcss: & 3oo Leqacu br
Phone No 4L,q - q1b -bb37
E-Mail S}crra .6 | ahots e-er;csso^,.ott1
State or County Lhense.4ECl5]-6 t 3f-
Name: Slcva Nlchals
Company : Eri cSeon rrr
Crty:State: XL
Zip Code 16Deq
-uvlJl anb
Permit Number: _
CBDG Funding_
tot No._
Bbck o._Site Plan Name:
CONSTRUCTCIN INFORMATION:
Mail: a^A/-..^ , u>i k<+.,-.a\ Oa,lr.ozlr.+ l: nl16(d g.
Fill ln lee slmpk Tide Hdder on nert page lf atdmdaa
frorn dre Oixncr Estcd abo,e)
Fax:
DESIGilER/EilGlilEER: _t{otApplicable
zip:3a5?q al3 -P e .l- b3t sState: ,=r
Address:
Crty:
Name:ILC-Cl
MORIGAGE GOMPAIfY:
Name:
Y rot Applicable
Phone:z,p
State:Crty:
Address:
FEE EMPIE TITIE tlOtDER: _ Not ApplicableName:M
Address: qOSo 5 D.can br
zip
City :6€,1sc^ B..h t=L
BOIIDI]IG CiOMPAITY:
l{ame:
X Not Applicable
City
Zip:_ Phone:
Address:
OWIUER/ OOITITRACTOR AFFIDVIT: Appl-nation is hereby made to obtain a pemit to do the work and installatiofl as irdkated
I certify that no wolt or iostallation has comrnenced priof to the issuance ot a pemit
St. Lucie Countv makes no reoresentation that is rrantine a oemit will authorize the oermit holder to build the subiect strudure
whidr conflics'with anv aDoficabh HomeownersAssocialioir rules- bvlaws or and cotierants that mav restrict or prtthibit such
st udure. Please consuh iiih your Homeowners Association and ield* your deed for aoy r€suictioris whkt may apply.
ln consideratbn of the gnnting of this requ€sted permit, I do h€reby agree that I will, in all respects, p€rform t'le wort
in ac@rdance stith the approved plans, the Florida BuildinS Codes and St. Lucie County Amendments.
The follosi.E buiHing permh agplkations are erempt fiom undergoirg a full concurrency r6,i : room additions,
strucbr€s, swimmint pools, funces, walb, signs, screen roonE and accesso.y uses to anodler rxrn-resirrential use
TO OW ER: Your hilure to Record a tlotice of Crmmencement may r€suh in paylng twice for
ments to your prop€rty. A t{otice of Commencement must be reco rded in the public reco rds of St.
nty and posted on the jobsite before the first inspection. tf you inten d to obtain financin6 consuh
der or an atto before commen work or recordin r Notice of Commencement-
Agent for Owner
Physi6l Presence or _ Online Notarization
this
(Signature
co--ioi* mI [0t34/3
t
subscribed L
of
L.
(or
dav
uced ldentification _
of owner/
Public- State of Florida)
med
bV
ASHLEY L. DAVIS
r\lY c0MMlssloN4 HH 082913
EXPIRES: January 20, 2025
acidod Thru Nobry fubllc Und€n$it6r3
STATE OF FTORIDA
COUITTY OF
SEA TURTLE
REVIEW
MANGROVE
REVIEW
REVIEWS zot{rr{G
REVIEW
SUPERVISOR
REVIEW
PI-ANS
REVIEW
VEGETANON
REVIEW
DATE
RECEIVED
DATE
COMPI.TTED
(seal)
Name person
Personally Xno n
FRONT
COUNIER
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