HomeMy WebLinkAboutBUILDING PERMIT APPLICATION-
AI:L AkPPUC/AB,LE,'INFQ: Iu UST'BE QMPL 7 EI ; FO :APPLICATIQN,.TQ BE.ACCEPT ER
DateyJ & PermitNum
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uil g permit Applrcatio JUN 06 2018
Planning,and pey..el6pment Services;
Biu�drny:vnd cQd°liegurot�oo ��,s,4 P6eermitting D e p m e n t
2300 Virg'irna Aye`nue, Fort Pierce FL 34982 St L C .e my FL
Phone: E772r462 iS53" Fax (77jr#6 1Z& CE�ttiRf(�rCrE ;Y r
PERMIT APPLICATION f0 __.._.._ _..:_.
PRIOPOED IMPR0IF_E_MENT�L_OCATIQN�
.hr.- - .Nr �.«..�,.,: .r-FN .S .`✓•V .mt. •Ar,Y 4r '� .art :^Y =n
Address: "" a50 af&(V'e Crete )�,(Z. fir+ S+ - L►.u✓r �. 1 3LlgHo
Legal -Description ,,Ve5fN.t--,Cc:fe-G._... _..rC.� _.__..� Loi- I q qo a-- 4/f of Se,.C_.. ..-3co,.-.3,., .
► � • ore as' or ay e al No 4 l ' l 3 V t5( H ► odI133
Property Tax. ID #: 33a- - to o I - 001- O OR - Lot No: 1,57
Block iVo.
Project Narrte
'Setbacks Front Backs itigit Srr1e; deft Sizle:.
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DLTAI`DfSs✓R�PFION C�fRt\T SST k FSE l%fr4a i. t7S SR f rtr L FAtiT
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'Additionat wor. t e ornie un er # �g permit - c ec, .a Ma y,
U`Gas
t AC Tanaws/Door
Ele*1c. Plumbing- Sprmklees Generator K�of:plich
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Name:
Addr12Se(w Crfe[~ 1DR.
Cgn'fpan'y S+ L4 G �'n
City: Pik+ S+ LA c j scatL
Address:-K l3 nAAo a6jA, _
Zip Cade.:. .q:$l o ...:
Phone Nv:__Q")a-QS/S It rFl I I
Zip Code: 3Ll Fax: '7'4-,7l0r7-'735`
E=Mail:
--Phon&No- 1-7 9JL SL44- r-) IG
Fi1f iSt fee simple=7'itfe, IfioFder`Or`r rreict° page f `if'thffereeri "
= E Nia'ri: S-F- b6 { �1(!@ jcAnd.. C_�Nnl
franc#b inRnei• {isled'ahove)
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Ifrrialbeofconstruciioiris$2! dWb tici,rea tibRDEE?ltt fC 6f'Corrimeircemetitisreyirited:
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:-DESIGNER/ENGINEEW. _vot.Ap
Name:
-'M0ATdAGE1t6MPrAUYrNat Applicable
Zip:. Phone,
Zip � Phone-
FEE SIMPLE TITLE HOLDER: Not Ap
city!
Vhldhij'
Ilicable-
... ...... ..
.15ONOING-COMPAW: Not Applicable
ddress
city!
0 W N E Rf - C 0 UT KA C T 0 1 t A F F I I Y VIT .--
[certify,that.no- work or UnstaRatfion-has, c
5fjucie.'Cbuntv makes no representation
in accordance with the approvedplains, the"Plo
TLh_efc;ffo.w1`ng'6u0ding permit applications -are i
iin'g".1 p-6'6Is'je'nc'e"s',,
WARNING TO OWNER: Your failure to,R
A'N16ti
'etithiinAfi
k�li-s".Fre"r'eifilly--,-Im,`aldle't"v-a6t"jir'rl'al,pefafio'do the work and tnsCailat"rorrasrndicatecC
!d prior to-the-issuanceof a.permit.
a �, fing a,permit - will"adthorizetfie permit "holder f6build "the subject structure.
Association . rules
g6ciaboil and, review. your Deed for any. re, �ma
t�o 'r
d d strictions-whicb. may . ply:
at "i -i7t -h&6lJr , 6:th*. A t 1 -16-51 F , -9ft --#bitf 4
'it - dd. -J& te edtt cirm -h
Building Codes and -StLucie County Kmendments.
4tfrom: undergoing a-ft0concurrency. review: room additions
Notice of Commencement may -result in your paying twice for
iftr�eftb`Md hf M&f '& 46& &cN postehej66§ifd
ain-financing,.consult..with.IL-ndL-r or art attorney before
-
Sigirfdtwe �titi;dictdr-d!�
r owif&
SloittyrW of cerise 1461der
STATE. OF. FLOR1104
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STATE OF, FLORIDN
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66 f6r9049 16904meni. was ackriawledged b'e'f
The drg6ingff ttUeht Wa knowledge'b fore,me
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this ,iy
this-21—, OY-9f 01
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Nameo�`ofoer�on�gstoiement
'iN'4m-ie6-.-pdrs aalong statement_
4nallktu�
'type
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_Personallykhown, ertifation-
6fideintiflcaiion
Type of Identification
proddced7
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(Signature ofAotary. Public- State of Florida -J.
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CONOYANCE PROULX
6
tmmis'sion No.. oaffsT�INCE PROD
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mission No.
MY C0MM1SS10K6i4#)160517
160
MY COM41SSION FF FF 16(1
17
EXPIRES September 16,2018
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308-0153 FIwiONotaryService-com
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