HomeMy WebLinkAboutBuilding Permit Application Aii.'AIsPueA= 6 AI d r'sE c*a6iEm FOR AfKJCATlGN'F>D'BE AC ED
Date: q .- Permit'Nurnber: r 51 a d oab
RECEWrD OCT 012015
B i i g Permft-Aoo ➢cation
Planning and D9WtaPment Services
Buildirig and Code Regulation dtblslon ;
2300 Wrgihia Aventte,Forr Plerce FL 34$ V
Phone:(M)4Q-1553 Fax:(7n)462-1578 Commercial Residential
PERMIT APPUCA'f N FOR'- Other \-A V a'. - C.o to� C7
now
Address: R('T -5• �Lek A irl {� ���-E.� _J 'q
Legal ReScription• �.kYl r GI DRd o►Yi i n i�
Property Tax-iD#: 2' �J - Lot No.
Site Plan Marne: Block No.
Project Name:
Setbacks Fronk Back: Right Side:��..�left Side:
1DU:C TaN lLk ID
SPLI T 6isTe-rn
wor erne un er s erm —C � a appRIffal
VAC Gas Tank Gas Piping _Shutters ❑1NlndowSJDoors
DElectric 13 Plumbing LISprinklers Generator Roof
Total Sq.Ft of Construction: So.Ft.of First Floor.
Cost ofConstruction: oD Utilities: , Sewer ED Septic Building Height:
Name Name: n
Address: Company:
State:F--- Address' IDC hj1FjiYi'j_
WIA
Zip Code; �7 Fax:_ CRY: State:,E.,
Phone -_9941?9 Zip Code: Lq JCI q- _ Fax:-772
E-Mail: Phone No.
nil in fee simple Title Molder on'neA page'(if different E-Mail:V' u
fromft0 merfisted above) State ontyrw.
if value bf cons ctlon jj4z5Wor more,a REODRDED Notice of Comu"tement is regWred.
E0/Z0 3Jdd z13IW3Jd b60ZZ69ZLL 86:17T 5Z0Z/Z0/0Z
. f
f�ES(G 'firiltililflEER: Not'Applipbie 7Address:
COMPANY: �Not ApplicableName: i Address:
City: I Mate: City: State:
ZIP: I Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Niit,Appticabfe BONDING COMPANY: �Noi pplicable
Name: I Name:
Address: Address.
City: I City:
Zip`.. .... I,, Phone: I :.
Z'P: - Phone:
I I
I certify that no work orlastallation has commenced prior to the issuance of a permit.
5t.Lucie Coup ' makes no representation that is granting a permit wiN authariaethe ermit holder:to build the subject structure
which is in con ii t,with any ap�plicabie dome Owners Assoctati�tn ruses,i�yiaws or andcovenantsthat may rstritt'or pmhibiz such
structure.0e o consult with your Home Oiuriers Association and review your-deed for any restrictions which may apply.
In confides#ion of the granting of this reyu6ied permit,I do hereby agree that I wilt,in all respects,perform the work
in accordance with;the approved plans,the Hdride Building Codes and St.Lucie County Amendments.
The following building permit applications are.;exernpt from undergoing a full concurrency review:room additions,
accessory structures,svAmming pools,fences,,walls,signs,screen rooms and accessory uses to another non-resideritial use
WAtiMiNG'TO OWNER:Your failure to*Record a Notice of Commencement may:result In Your paying twice for
Impprovernen'�s to younproperty;A Notice of Commencement must be recorded and pasted on the jobsite
before the fi st.lnspection.-if you intend to obtain financing,•consult with lender or'.an attorney before
conimencin Work or recording 'ours Notice of Commencement.
.•
she/Agent f tkf�� r,Uter}se!Holder
� I �.. . ...r;h.,ntaiti4
STATE OF F b � STATE OF FLORIDp({/I
CGUNiY:OF COUNTY OF t Y L
The �i instryment was admowled8* .• ore rte me ng Instru yen w acknowledg d efgr me
thlsd ' 20 by this day'of ,,20by
(Name of parspn.aclmow]ed$ing) (Name of person ackno ted ink)
r.
-Nis—naturd0f Notary Pu lic-State of Florin 'I) (Signature 4fotary Public-State of Florida)
I
Personally Known OR Produced I Ontification _ Personally Knovun (OR Produced Identification
Type Type of Identifl o ce
Corn �'' '`° MY COMMISSl4N F9 =': ►: MY COMMISs �FF904048
Commission No. d
EXPtItES,July 31.;2014? „No -
- --EXPIRES July 31,2019
t rr, s99-ot,s FlorktnRo serNoa,cbm �8 tiQ/3388��59 FIot108Nert78ns9Nk9.Caf�'
Revised 07/1512014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW . REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
EO/Z0 3Jdd H3IW3dd b60TZ69ZLL 8E:b1 STOZ/10/OTI