HomeMy WebLinkAboutIrvin Schimelman - 43666ST. LUCIE COU�TY PERMIT APPLICATION �7VY1414-t
PERMIT NO. �W4_ ( CODE # ) SEWAGE PERMIT NO. —�
APPLICATION FOR PERMIT TO CONSTRUCT 2"4, c'f
JOB LOCATION/ADDRESS: yWl -�_Al/2 ' / 7 ern sr, ✓ .�. /� l"I'VEWAY PERMIT.�' S73 V 5 7
LEGAL DESCRIPTION
Yes
---- No
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ROAD IMPACT: DISTRICT ZONE FEE
S/D 12&AA /l /�FS42Ts MAP #
LOT / 7 Y BLOCK UNIT SEC —
PROPERTY TAX ID #
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FLOOD ZONE ELEV
TWP
RGE
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LOT SIZE/DIMENSIONS �`�,�%" r/% d -7 6' EST COST GdU 4l1
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SET BACKS: FRONT 2A Z s' __ REAR SIDE _ SIDE _ Z
SQ FT BUILDING: LIVING AREA
ARCHITECT: NAME
CONTRACTOR
ADDRESS
ACCESSORY
CITY
PHONE
ST ZIP
STATE REG/CERT ,# _ COUNTY CERT #
CHAMPION ALUMINUM CONTRACTORS
NAME P.O. Bex 1847 ADDRESS
Jensen Beach, Fla. 33457
CITY STATE ZIP
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PHONE ,129 IIF
OWNER OF NAMEZ22y)A"
PROPERTY:
ADDRESS Z�1'5"l S - fl dd 4'/7,9�;- PHONE
CITY ��'NS�� �5�` STATE , � - ZIP'1 --�' q _5
STATE OF FLORIDA, COUNTY OF ST. LUCIE
Before me, the undersigned authority, personally appear ' 1117 P who upon
being duly sworn, deposes and says that the information cont fined i the fo g ppl'c 'on i true and corre, r.
Applicant
Sworn to and subscribed before me this_day Of
SCHOOL IMPACT FEES
Required [Yes [] No
Notary Public, State of Florid at Large
Amt. I'd
My Commission expires: �-��-�?-_-��;
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