HomeMy WebLinkAbout1612-0282-BUILDING PERMIT APPLICATIONALL APPLILAULt INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED q
Date: '4
SCANEYED Permit Number:BY
t1�
Lucia Comy
RECEIVED
_.L Building Permit Application DEC -15 2016
Planning c nd Development Services PER-MI77ING
Building a'Iid Code Regulation Division St. Lucie County, FL
2300 Virgi is Avenue, Fort Pierce FL 34982
Phone: ( 7, 2) 462-1553 Fax: (772) 462-1578 Commercial Residential x
PERMIT I�" PPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IM,PROV.EME,NT LOCATION
Address: 1
Legal Desc
S OCEAN DR 866 JENSEN BEACH FL 34957
VENTURE OUT AT INDIAN RIVER INC LOT 866 (OR 3765-2680)
Property Tic ID #: 4511-510-0067-0004 Lot No. 866
Site Plan N Ilme: Block No.
Project Na e:
TLUMACKI - SIDING
Setbacks I Front Back: Right Side: Left Side:
i
DETAILS' DESCRIPTION;.OF WORK:
INSTALL LID ING ZoA 2 D
Vi
CONSTR, CTION INFORMATION
itiona or _.
tobenerformed under this permit —check all tLd apply:
�HVA 0 Gas Tank ❑Gas Piping 0 Shutters []Windows/Doors
Elect Iic 0 Plumbing F1 Sprinklers l Generator E]Roof Roof pitch
Total Sq. Ft'o f Construction: /ems o 0 S . Ft. of First Floor:
IlIId�
Cost of Con II struction: $ � -�"oo Utilities: D_ Sewer 0 Septic Building Height:
OWNER%
ESSEE: _
"' CONTRACTOR: ;
Name MAR
Address:271Allen
City: WAK
Zip Code:
Phone No. 508
E-Mail: mti4lmackj@gmaii.com
Fill in fee si
from the
I& LESLIE TLUMACKI
NaM-1tz, MIK OLEMAN
Co OL N INC
Ad ess: US H 7
City: TEQUES'fA State:
Zip Code. 33469 F : 561 743 87
Phone No. 7
E-Mail: E C.0
State unty 'ens CB 50
AVE
FIELD State: R�
2879 Fax:
6541639
II pie Title Holder on next page (if different
I ner listed above)
I�
If value of construction is $2500 or more, a RECORDED Notice of Commencementlis require'i. \ ---N v
SUPPLEMENTAL CONSTRUCTION LI'EN;LAVV INFORMATION;
DESIGN E 1R/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: 1; Name:
Address: PI Address:
City: PI State: City: State:
Zip: I Phone: Zip: Phone:
FEE SIMP�E TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: h Address:
City: l City:
Zip: II� Phone: Zip: Phone:
11.
I certify thdt no work or installation has commenced prior to the issuance of a permit.
i
St. Lucie Counttyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in cr�onflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Iease consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consider6tion of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The followin"g building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commenai w or recordingour Notice of Commencement.
1
nature of Owner w R, ;; Signature of Contractor/License Holde 41
STATE OFI�t9R1Dig►� L STATE OF FLORIDA
COUNTY OF CAS , i l u'' COUNTY OF
The forgoing instrurgent was acknowledged efore me
ELK -
this day of lby
4CA
t C, � 0-e
(Name of p `i rson acknowledging)
(Signu're'1 f Notary Public- State Of Flcflda1*u= _'`��r
Personally I'n(ARIA C. KAMI5IR Prod"a •.I eril l�ltloh" r `�
Type of Ide 'tiH@ y k1&d `
S ATE OF RHODE ISLAND =-,, tco
corklyi�opj kwinN EXPIRES 01102 01$(
Revised 07/ 15/2014
The forgoing instrument was acknowledged before me
this day of . 2 uo_ a '
(Name of person acknowledging)
(Signature of Notary Public- State of Florida )
Personally Known OR Produced Identification
Type of Identification Produced
Commission No.
(Seal)
REVIEWS
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DATE
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INI N ° 25