HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALLAPPLdCABLE INFO MUST, COMPLETED FOR APPLICATION TO BE ACCEPTED
Date _ _ • OSLI SSr.r,
... _
SCANNED
ANNE
Ouildkiilg ?:0110Mit Appliation St. eY
Planning and Development Services Lucie COU
my
Butlding,arid CddeRegviption Division '
2300 VJrglniaei(7Avenue; For'
Pierce FL 34982
Phon72)46 4553 Fax:(772),462-1578 COti met'Cial Residential X
PERMIT APPLICATION. FOR: Renovation .-
Addressa
Legal Descnption:.
PropertyTax ID Lot No
Site Man Name..
`: Block No.
�project .N,ame:
%rrSetbaclo Front ' Back Rigfitside.. ` L`effside:
.Additional work o e orme un ec s perm —c ec a apply:
LjHYAC Ga "Tank �GasPfping Shutters -; QWindowsJDoors
Electnc L" ! Plumbing Sprinklers Generator _ „< Roof Roof;pRch a :� o
'Total S4. Ftof Construction , = S Ft of First Floor
Cost of Construction: $ yD w Utilities Sewer I j5eptic Building Heigh!,.'
.: Name..Vu r- 61 - Ju9Vn;C Thipry-,_
:... .. - . :
' ` Name:
Address.,; . Company , Island`46tchen and 13atli of theTreasure'Coast
id875 S: Ocean Dnve ` ,-, r _ •' City`- � State:.; Address:'
Zip Code: #ax City Jensen 8eac h , , . -State: Ft';
w -
-, Phone.Nd. '' „ Zip Code 34957 ' `Faz;
E-Mail: = -Rhone No. 772237-7348`
Fill in fee simple Title Holder on next page ( If different • ` E-Mail: )thieryikti@bmail.cgm `
-= from the Owner listed above) w i5ta4or,Couoty License; CRO1264608'
It value, of. construction is $2 or more, a RECORDED Notice of Comrtiencement is regylred.
MORTGAGE COMPANY-_` x Not Applicable -
Namfe:,sNa'rrie
,
Address `
:Address -.
'Glt state
lio,., :,Ixs,phone:
IT-
Phone:
FiEtSIMPLE TITILEMoUnk; 'x Ndt,Apollcable
- 11 1 % , 1. - — 1�
'BbNDING C'OMPAINY:
- , - _Oot�Aoplieible.
ame:�
, �
Name:
Addrem
Address:,
City7
City:
Lp op
Zip:"
i certify that no work orinstallation has commenced ,prior to.th6issoarfce o CapprinniV, '
It- e Coun makas no�represiBnwtlon•that Is grainting-a'permit 'Will authorize ermut hoAde'r",to'b6ild the subject structure'
which in co17 n Ict with anyapplicable HomeOwners Association, rules' .bylaws, 1 Covenants thgmay restrict,or prohibit such'
structure.,Please con Wit,h.yd,ur Owners Association 91 FC
-suit, .and .-i.eview your rany,restrict ons which may apply.
Antorisidbration of granting of This reqiiestiid pedrml�,l doheirefiyragree,thiii',Will;,Ih altrespects, perf6rin the Work
,in-i6Eordih7ce�41ih'theapprbVedpli'ns,:thiFi6oda Bbilding,-6dis-indyst.,Lti-ei6County Amendmenfli;,
The,following building piijrrrilt tipplication s are 6xiurift from undergoing a cull concjrrencyreviewirocim. additions;-'
accessory`"structures, swimming pools, fences,;walls, sign"s,'screen rooms and accessory uses to another non-residential use , °..
, .
WARNING TO,OWNER You�fallure to Record a Notice of Commencement mayr`esuit In your g.twke for
improvements to,your property A Notice of Commencement mustbe recorded and posted oh the jo
before the first inspection. if you intend to obtain financing, consult with lender `dran 4ifbinriqy-bef6re'
51gnatufe of,owniarl.Lesseel _COM2�ctor asAgent,for Owner. 7
Sign tore Co, teat Ucen a Ho de r
STATE OF FLORIDq
' S*ft-OFFLORIDA
Co OF
touriily do ww*
e omoing in rumen was C
f st'tc6 )wIedg6d before mj.�,
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(Name,9f-person,acknowlcidging•)
:jSil;h6idre-df,N0tery Public-S fflorida)-,_ Nota�j 1aSfBitebf*loridal)
�kinailjiribw .,;�bi'Producedldehtl t �ers6ruili` �-n:i
-��6kProduced'idenilficat]6n',:
; on Produced entification Produced i
1�oi pu, 'MICHAELRAAZ
�S*t0fAIISSiONI.F179101491 isi ICHAEL RAAZ
71 I-MYCOMMIS 10
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