HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONl
ALLAPRJC/CE3LEINFO MUSrBECDMPLErIDFC)RACPPLIWCNTOBEA0CPf1M
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Date: I c)' 2-' I ? Permit Number:
SCANNED RECEIVED
BY
Bui�6lh PaRWf'�pplication
OCT 2 2 2018
Panning and Development Services
Building and Code Regulation Division ST, Lucie county, Permitting
2300 Virginia Avenue, Fort Perm R-34982 1/
Rhone: (772) 462-1553 Pax: (772) 462-1578 (bmmercial X Fbsidential
PEW ITAPPUCA11ON FOR To Select from dropbox, click arrow at the end of line
M.
PropertyTaxlD#,( 6962—<5nD - D/.S/o—Dt7�'8 Lot No. XDa
Ste Ran Name: F3odc No.(a
Project Name:
Satbacks Front Fads: Rght Site: Left Side:
DEMILID DFT3RIPFION OF WOFK- III
(,3 'Aee ions on Side
OONSr JCIION INFUMATION: III
❑HVAc IJ(asTank ❑CasPiping 3wtters E]Wiindows(Doors
❑Bectric ❑Plumbing ❑ prinklers ❑Generator ❑Fbof ❑ Roof pitch
Total 81. R of Cbnstruction: 3�I�R.. of First
l Poor:
Cost of Construction: $ V/ J��� dy Utilities L_jSewer L_J We Building Height:
OWNEFVI
OJNTPACTOR
Name C(CA, re
Name: f
Addis e V/
Company: h
City: ra_ `e sate: FL
21p(.ode,3q'?.7c2 Fax:
Phone No. R7k-o2(v
Addre _ r
City: Stater
ApCoft Fax: AIZA
Phone No. 7 a ' 370 - U
EMalk
RII in fee simple Title Folder on next page ( if different
from the Owner listed above)
EMail: U
State orCDuntyucense:
If value of construction is $2500 or more, a FEDDR)ED Notice of commencement is required.
DEEIGNffYBJGINEt
_Not Applicable
MORiGAGEO0MPANY:
_Not Applicable
Name:
Name:
Address:
Andress
aty:
Sate:_
aty:
Sate:_
Zip: Fhone
Zip: Phone:
FEESMRETFTLEFIOLDER
_Not Applicable
BONDINGOOMPANY:
_Not Applicable
Name:
Name:
Address
Andress
aty:
My:
Ap: Phone:
21p: Phone:
OWNER OCINTRACTOR AFR MAT. Application is hereby made to obtain a permit to do the work and installation as indicated.
loertify that no work or installation has commenced prior tot he issuance of a permit.
3) ige.Qtount�.malcegnorre�re,% ion that iscaanntt�'ngapermitwill9thoricethe ermitholdertobuildthestbl�ect%r%,ture
wf 1 Ism n ict wrt an ph a Floa Qaul rs ngsopli ru eS ylaws r an8mvenantsthat m restnct or pro 1 R sidt
structure. ease consult It your me ners aatlon and review your teed for any restrictionsu hitli may apply.
Inconsideration 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 Rorida Building Codes and 3. Lucia (bunty Amendments
The following building permit applications are exempt from undergoing afull conourrency review: room additions,
accessory structures, swimming pools, fences, walls signs screen rooms and accessory usesto another non-residential use
WAFININGTO OWNER Your failure to F000rd a Notice of Commencement may result in your payingtwicefor
impprovementsto your property. A Notice of Commencement must be recorded and posted on thejobste
befor first in ec tion. If you Intend to obtain finandng, con ith lender or an attorney before
oom enc w or r din our Notice of mmenoemen .
A
Signat of Owner/OFFLOUppLessee/(b t for Owner
Signatur ntrantor/License
MYOFF S . roc \C
UNTOYOV S
The forgoing instrument was admowledgedbeyreme
Thefoff r Inginstrumen was acknowled lbeoreme
this �day of escok 20 1_A b
this�lda of c" 20] b
Name of person making statement
Name of person making Statement
Personally Known OR Produced Identification_
Personally Known OR Produced Identification
Type ofldemifi ion
Produced— L L,
Type of Identification
Produced
—�
(Sgnatureo O't3rt Sn gyEGIVENS
(9gnatureofNotary Pabkio-
_ateofRorid
Qlmmission EANwy{yE GNENS
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c: ;eE rAISSION#GG 022023
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Cbmmie9on - _i 16,2020
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•.,,,,..•• Thru Notary public Undervrtilers
'� EXPIRES: December 16, 2020
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