HomeMy WebLinkAboutBuilding Permit Application is
i
ALL AP ICABLE INFO M ST BE COMPLETED FOR APPLICATION -TO BE ACCEPTED
Date:
1 Permit Number: 1505
I.
Ouilding Perrhi Application >
Planni and DevelopmentServlces
BulJdi nd Code Regulation division j
2300 Inlet Avenue,Fart Pierce FL Md V j
Phan . 772)462-1.553 Fax:(772)462-1578 commer�lal Residential
i
PSR APPLICATION VOR; To Select from drdpbo , click arrow at the end of line
Addres too
Legal D iption:
, RR
L�
Prape ax iia#: �'���" �(� c �' �� � •"' ...
LtrG O-
I)
Site Pia
ams: I g1aGk No.
Project me: ji
` is
Setbac Front Back: Right Side:,_.. I� Left Side: !:
li i� •
A-45 K16/
2 c�3 -1-nn
. .
Aci
�� .di-tyio wor to e e orrne un er is permrt--c eC a appy:
E JH .0 1,6asTank ❑Gas Piping _Shutters Windows/Doors
OEl is Plumbing ❑Sprinklers Generator Roof
Total Sq. t of Construction: So. t-of First Floor:
Cost of :instruction:$ Utilities: Sewer Septic Building Heigh
s.��
Name — Name: i
Addr 13,9ffSE Co npany,
' States Ad ress
Cityr:M '— LL J
Zip Cod : � ..� Fax: Cit
Phone N 21 t�' �L)15 0�� Zi Code: ��`7�'" Fax: O��" 52-0 �
E-Mail: Ph neNo. -54- r -71.e-DQ
Fillin fel imple Title Holder on next page(if different E- all:
from t}i wner listed above) St a County License:
if value 01 Mnstruction is$2500 or more,s RECORDED Notice of comi nencement is required.
E0/Z0 39Vd KV HOV3R N3SN3f 68L985EZLL ZI:TO TT0Z/0Z/T0
!i
Al-
DESIGN JENGINEER: Not Applicabie mOj{feApiE COMPANY: Not Applicable
Name: Name:
r
Add Adsfress: 1 ---
Clty: State: lwl#fy: 1: State:
P.
Phone: Zi :_ Phone: `I
FEE SI TITLE HOLDER: Not Applicable BNDING COMPANY: —Notlihpplicable
Name: Name: - -
Rddres Address: -
City: Ci 1'
Zip: Phone: Zi I: Phone:
;i
i cer#ify t :t no work or installation has cojnmenced prior to the Issue ce of a permit. j!
St.Lucie mit makes no representation#hat is granting a pbrmitwill iauthorize the ermit holder to build the suk%ject structure
which is i to nflict with any applicable Horne Owners Association mlesil bylaws or andcovenantsthat may restrict or prohibit such
structure, ease consult with your Home owners.Association and revl6w your deed for any restrictions which may,apply.
In consid on of the granting of this regOested permit,I do hereby a�ree that I will,in all riespects,perform the.dyork
in accord a with the approved plans,the Florida Building Codes and&t.Lucie County Amendments.
'fhe foilo r g building permit applications are exempt from_undergoinq'a full concurrency review:room additions,
accessory ,ructures,swimming pools,fencies,wails,signs,screen ro4 s and accessory uses to another non-residential use
WARNI TO OWNER;Your failure to.Record a Notice of CoAmencemer t may result In your payingitwilce for
improve ents to youf'property.A Notice of Commenceni must be recorded and posted on the jobsite
before t ' first inspection. if you intend to obtain finan;cino,Consult with lender or an attorney before
comma in work or record { Notice of GommenceiTrent.
signature , C+wner/Agee Lessee sign Lure of Contractor/License oider
STATE FLORIDA STi�OF FiORiDA
COU F6d A CO NTY OF
The f o g lnStr m nt acknowledged before me :The o going instrumen acknowledged b2f re me
this y of 20 by this�ay of .20bryj
(Name o rson a knowle ng) (Na a of perso acknow 'dging)
{i
Com"
(Slgnatu NotaryPu ie a of Florida) (Slg�ature of Notary Pu lic- of Florida) }
Personali own ,_OR Produced Identification.._ Pers naily Known OR Produced Identifliation
Type of Id tification Produced Typo of Identification Produced
Commissi I 191. AL VAR19 Ission NoRa ikrAiEGfiu
_A r. MY CCIMMISSi()N qI EEi 463 6 +a ;z my=ISSION 4 EEi97
E7ti�IRF.S dune f.2016 ..
Revise c r 7/15/2414
*,W
aaao,ss "N..�ViftiV":..� .rr ssa wee s•^�*►�,�
;i
REVIEW FRONT ZONINGSUPERVISOR PLA'I'NS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW ! REVIEW
DATE j
COMPLIF !
INITIALS
it
11
i
£0/£0 39Vd HIV HOV3S N3SN3L' i 6£LS£S£ZLL Zti:T0 Z1:0Z/0i;/t0