HomeMy WebLinkAboutBuilding Permit Application ALL
APPLICABLE MUST BE COMPLETED FOR APPLICATION TO 13E ACCEPTEi
D. i N r r
RECEIVIED MAY 12 2015
' i i • mit Application
Planning• • Development
Building•and coder t ♦ Division
ff Virginia Avenue,Forti'
Phone:
i 4.62-15.53 R Commercial Residential X
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Address:
fiLAS *LASOLAS DRIVE,JENSEN BEACH,
BEACH M f OR 564-658: 1109-1677;21fe i
2105-2702: '.
4511-500-0020-000.2 Lot No 10
Site Plan Name, Block No.
LAVVRENGEICAROL
Setbacks Front Back: Right Side- Left Side;
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0 Fn-e--d under tff-is permit-r ec a that apply:
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..ta.[C_ "a.r 4. .?u.•WS]. 1•
Total[0HVAC OGasTank ElGas Piping Ij Shutters Windows/Doors
1 0 Electric Plumbing 05prinklers 0 Generator Roof
, Floor:
Cost of Construction:S 4717.00 Utilities:OSewer 0 Septic Building Height:_
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City. State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE.TITLE HOLDER: _Not Applicab[e BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucle County makes no representation that is granting a permit will authorize thepermit 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
structure: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,f 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 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
commencin work or rucirding your Notice of Commencement,
e�Z IYA_.., 14z:-ol,4 _jZr�_ s
ZAT
ature of Owner/Lessee Agent ' y�! � - Si ture o Contractor/License Holder
fE OF FLORIDA K STATE OF FLORIDA�/�/�
COUNTY OF �� _ COUNTY OF V r ►Q�11
The forgoing instCurnent was acknowledged Wore me The forgoing instrument was acknowledged be ore me
this_t,?,day of IV fAt4 20 J.15by this day offflefj20 by
��h 8::9A � fn h ��
(Name of person acknowledging ��� (Name of person acknowledging)
qh — (-m'liffi,
(Signature of Notary Public-State of Florida) (Signature of Notary Public- JA- M.
f Florida)
Personally Known p OR Pro cation Personally Known�OR Produced identification,_r
Typet-,`;fit o�{i1H9 Tv i ion ro uce
MICHELLE-
• }•1 MY COMMISSION#W1 a '�
Comm 1 �ea Co i 1 n; MY COMMISSION•#FF1007a5( eal)
►� EXPIRE arch 28,2018 ,�..._••• EXPIRES March 23,2018
•�� Hata Servlco.eom
Aevised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITfALS