HomeMy WebLinkAboutBUILDING PERMIT APPLICATION� J
AltAPPLlCABI E INFO MUST BE CONE 111) FOR APPLK .WN TO BE-ACCEprED .
Permit Hum b - q�
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P/onningond0ev g ermitt Application 610190.d35
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Building and Code ReglaCon DbWW
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Phone:(m)462-),553 Fax:V72)462-1578 Commercial
Residential
PWMIT APPLICATION FOR. To Select from dro
PROPOSEn�aiiiarir iieIiAi1a .',k _: _ SOX' dick anOW at the end of Jin®
Address:
Legal Dexdptton: -
Propertyux li : y - Goa - (ja
Site Ph'n marne� mc GL
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Lot No.
Block NO. :
Setbacks Fiont_ /O , Bad Ly fight Sidc / r r
LeRSide:�
�EPA(LEp'bESCRIPTION OF WORK.
Nth K G CAs INE - Ex)STn/ Cc G
w �ie�pLtc ��Cao,-/NE6� F,,q
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f_ AC Gas Tank Z Gas Piping —Shutters
_ Electric _ Windows/Doors
_ Plumbing —sprinklers _Generator
TotaiSq FtofConstruction: _Roof Roof pfth
Sq. Ft of First Floor.
Cost of Construction: $ o?.!/pp fJo Utilities: —Sewer S
._ ePl'rc Building Height
zP Code 3SI 99a Fax: — - —
Phone IYo.
E-Ibiail:
Fib in teOOInOeTitte Holder on next p (lf aid rem
firm the Owner RsW above)
Company.
Zip Code:...... 7 C1 Fax - d
Phone No. _ 4 � _ , I S
E-Mail:
State or County UcerLW O.S = cri ra
uD or more, a R€CORDED wae!w of Commeneement is r®aulr¢d 'L �f O
Name:
Address:
City:. State:
Zip: Phone:
FEE SIMPLE TITLE
Not Applicable.
Name:
Address:
City:
ZIP: Phone:
MORTGAGE COMPANY: Not Applicable
Name: —
Address:
City: State:
Zip' Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City;
Zip: ' Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application Is hereby made to obtain it permit to do the work and installation as indicated.
tcertifythat no work or installatlon.has commenced prior to the issuance of a permit
St Lude County makes no representation that is granting aD ermit will authorize tiie'permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
sbvcture. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration 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 following buildingpermit applications are exempt from undergoing a full concurrency review: loom 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
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STATE OF FLORIDg� ,
COUNTY OF, ((
The orgoing inst mentwas acknowledg efore me
this �, day of �20Vby
OCI
(Signature of Notary Pu IIe State of Florida )
Personally Known —OR Produced Identification
Type of Identification Pro
BRITTANY REDDIN
Commission No. ° tat�Cgblhorida•Notary Put
J+� Commission#GG19028
9y
My Commission Exoiree
ZONING
REVIEWS I FRONT COUNTER I REVIEW I S REVIEW
STATE OF FLORIDA
COUNTY OF _ ! 5* . ( L)C\E
The f rgoing instrument was acknowled before me
this' day of 20 by
��� � .
(Signature of Notary Public-Sta of Florida)
Personally Known ^ OR Produced Identification _
Type of Identification Produce
V"" R TTANY REI
ommission No °``
°�. S( RP Florlde•Note
=' = Commission#aal
My commission E
. uary
PLANS •VEGETATION SEATURTL
REVIEW. REVIEW. REVIEW REVIEW