HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONW
Nov 27 18,12:56p '� 1
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PLICABLE INFO MUSTBBEECOI � '
p.2
FOR APPLICATION TO BE ACCEPTED
SCANNED Permit Number:
BY
St. Lucie County
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 VirglnloAvenue, Fort Pier 4982
Phone: (772) 462-15 3 x:(772)462-1578 Con
PERMIT TYPE- F0unkt6I)y1 . ftfm.I
t" Residential
Address: V t IC
Property Tax lD N; M ip W 00 0Lot No.
Site Plan Name: Ty'(,Al-- W- Block No.
ProjectName:YfAfVvf COAS4'_ln{Yr/fdlioiM1ltlfx;raUri-.crhld,,�o n:YYI/tinVil,�ir.!'n�flrrrr.
Additional worktobeperformed under this permit -check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction:8S.9 S'(r Sq. Ft. of First Floor: _
Cost of Construction: $-&23L.®0 Utilities: _Sewer _Septic
_ Windows/Doors
_Roof Pitch
Building Height:
SE..,:.r`COIYTRAC7t7
si,e
M77kh
( I)U COUtt
Name: V W.
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%l(F{t�11iN PI1/
rA,ddresv6'00
Company:' OSLf7 f L SDAI 610iy'�tGC.
State: F
Address:14f20 S; INoN7ED�tl
1T lFax:City:
1-A1412(
State: F'LZ-
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Zip Code:SQ1g¢
Fax:22L_9Sf'�Z�1—
E•Mail:
Phone No -7 72 Z9'2
Fill In fee simple Title Holder on next page (if different
E-Mail Dki I & Wit)S%wn
and. �a eo vt
from the Owner listed above)
State or County License_
-----'- - 1lG VI lV111NIC111C111Cllr lSregalrea.
If value of HVAC Is $7,500 or more, a RECORDED Notice of Commencement is required.
Nov 27 18,12:57p p.3
SUPP! EMENTAI CCO�ISTRU7ION#l�(�N
7
tAtr� INFQRiY�AT10N
DESIGNER/ENGINEER:
'
Name:
Not Applicable
MORTGAGE COMPANY:
NotAppllcableY
Name:
_
Address:
Address:
City:
Zip: Phone
State:
—'
City:
State:
a e: —
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _
Not Applicable
BONDING COMPANY:
Not Applicable
Name:
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
r7r/dnlCn/ PAnlTonrs-nn ar•ren..,.-_
.
- --' 1 _.. .11...n s.-nriv I; Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
structure. Please consult uiltNyour Home oivners Assoe(a[Ion and reviewY our deed focovenants rici ons whichtma oapply.
Prohibit such
Y Y Y
In consideration of the granting of this requested permit, I do hereby agree that 1 will, in all respects, perform the work
In accordance with the approved plans, the Florida Building Codes and St, Lucie County Amendments.
The following 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
=rnmencine work nr ,.t r•,.......,..._____.
Signature Of Contractor Icense Nolder
STATE OF FLOTDA d STATE OF FIO,RII A
COUNTY OF 3 i1 VY� �4i 1 COUNTYOFJVIQf TLri
The Fo�oing Instrument was acknowledge beforeme
this y, day of NO7dtY�VI 2n,.,�i by
Name of n ..rsnn making ztatoment.
Personally Known 1./ ORProducedldentificanon
Type of Identification
Thefor Ding lnstr��rq��It as acknowledge before me
this2dayof 1 V • 21 t by
ll7 - I�Y1�✓(�2�.�
Nmne of person making staten4m.
Personally Known_ OR Produced identification
Type of identification
/I T '1/1.0{:✓,a 1-f 11ejx-jj
(Signature gf Notary Public- State of Florida) (Signature of Nola Pt,bAtatdlofiytBuYd"s Flcla of noriao
.P Mchote Oemakl
Commission No. //CCqq��'',, r lA Controls n.Gi30s5535
Netagan Mori State at Florida mm(sslon No. e Y f3Fe91A
Meagan Mahn ad 'E><Flm'°5/
iss(o GC 95010
's+q Expires 5/2021
REVIEWS FRO VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW R_ REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED tZ( /it,
:v. 9726Ji�—