HomeMy WebLinkAboutBuilding Permit Application ALL-APPl.IC0GE•INFO Utf$T 8E COIi'A'ptETED FiDk APPIJCATIDN TO$E ACCEPTED
Dj� ►l Lj Permit Number:
.::: .. RECEIVE-0 SEP 01
-:BU1W,1ng Permi#'A0011cation
Planning and Developinent Services
Building and'Code Regula don Division /
2.300 Virginia Avenue,Fort Pleme F134982 V
Residential
Phone:(772)462-7553 Fax:(772)462-1578 Commercial ��.
PIrRMIT APPUCATION FOR: Mer �v q C.
Address: 1
Legal Description:'
Lot No- —
Property Tax-ID#:
• rcd 012rJ- -C. L� .
Block No.
Site Pian Name,
Project Name:
Setbacks Front Back: _Right Side:—_ _—Left Side;,�•�
11:'I'lliz, 1:11011 2-mmililowl
`tea C� U ILIL f\ f �f�tt n �. �t c� `f�ON i I�
e� P - �0 kW
cti a wor a rote an er -1spe --c ec a app T
UVAC Gas Tank Gas Piping _Shutters Windows/Doors
[]Electric Q Plumbing Sprinklers Generator Roof
Total Sq.Ft of Construction: (�91 Ft.of First Floor.
Cost of construction:$ Utilities Sewer F]Septic Building Height:,•� ��
Name:
Name i
i Q& ke rp iSty)
NamesAddresloth ri n Vno l E f� Company: 1
State•) Add 1
7iCity.Code- Fax' .-
Phone
p No �— Zip Code: �1- `-t=� Fax:��
• .
E-Mail: Phone No.
Fail In fee sirttple Title Holder on next page(if
different E-Mail: QzQ'L'�,
from thebwner r'isted above) State or'County Li se:
If value of construction ls�$2560 or mote,a RECORDED Notice of Commencementis required.
E0/T0 39Vd i13IW3&1 b60TZ69ZLL bb:bT 9TOZ/16/80
{
DESiON lVFi: Not Ap(sIi cable MORTGAGE CdMPAVY: __. Not Applicable
ll
Name: Mame: x
Address: Address:
CEty: State: City: tate:
Zip: Phone: Zip: _Phone:
{
Fee sIMPLE"!rr:E HQLDEfe _Not Applicable BONDING COMPANY: Not''Applicable
Name: Name:
'Address: Address-, i
City: City: i
Zip: Phorte• Zip: Pi:oe
I certify that no work or•instaJlatlon has commenced prior to the issuance of a permit. :
• i
St.Lucie Counjy makes no repree�'entation that is granting a permit will authorize the permit 61 older•to build•the subject structure
which is inval nititt with arty appircnibie Hgtrre OwnersAssocEation rules,bylaws¢r and coven�nts that may restrict or prohibit such
structure.Please cons Ult with yout Nome Owners Association and review your Qeed for.any 1,estrictions which may apply.
in consideration•of the granting of this requested permit,I do hereby agree that I will,In all rfspects,perform the work
in accordance wltfrthe approved plans,the Florida Building Codes and St.Lucie County Amer)dments.
The following building permit applications are exempt from undergoing a full concurren;+cy review:room additions,
accessory structures,swimming pools,fences,walls signs,screen rooms and accessory uses to another non-resldential use
WARMNG,10 OIII NER:Your failute;ta Record a Notice of Commencemerit may rimult in your paying twice for
improvements tb your.property.A Notice of Commencement must be recorded and posted on the jobsite
before the first knIpection. if you intdnd to obtain financing,consult with;lender or an attorney before
comm+endrr Work or recordin V our Natice of Commencement. t
WAgent �crg rjl; erase Halder
OL
STA'V'E OF FLOR STATE OF FLORID
COUNTY OF_ COUNTY OF
The f in Inst 'ment wa cknowled fore me The ing Inst r ent 4W ac nowledg efore me
B
this day of _, 20[_;2by this dayof z0 by
{1.1
{tdame of person acknowledging) (Name of person acknowledging)
LUA
(Signature of Notxry,Publlc-State of Florida) (Signature of Notary Public-State Florida).
Personally Known. OR Produced lct tlfication� Personally Known V" ` OR Produced identification
Type of Id Type of ldentificatian P uced
lam, 111111 1111
Commissl '`= MY CoAnAf Stot�1'#�pst8 Commission N �B%` C��_$TAl�.A'{ UD0
E)(PJRES July 3#.2()1$ ••. My LoWISSION E PF904048
• taattS88-o<d3 Fb+KJeNotehsRrv{oe.cem
Revised.07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS 'VEGETATION SEA TURTLE MANGROVE
COUNTER RMI EW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
E0/Z0 39Vd d3IW36d V60IZ69ZLL bti:bT 9TeZ/1E/80 �