HomeMy WebLinkAboutBuilding Permit Application 1 I 1 � •, 1 � � 3� � II
•••• • • •
', .:FS�'z: .p [Si!av:"r ' ..1'-c"r- it 'r�^ r 1 r nw 1 r T ra;'v' �. t I r; +,°�t� •�i,�
s pyQ� L� f1' �} a �! F >'�f � a��w 174 r ' ?� IN
�.��'GC.�ldIMM11 ry1 /r� r t �i � 't.7:� !',�r 11.•i fu�:aY3tC�4 �f ,.13!LS'`i@+: l i'i((ift,3
r
ProjectV. UME
Legal Desc�iption:
Site Plan Name., Block No.
Side:Setbacks Front Back: Right
.- p
it.b'`•,�,j `•v"�6a1 l..LS�h`$'•; ' �,e�+ ,5 1�Y!t�"yip�i.o 8.:°sk.1' �k x� .�.�dw4o.�layw�hes"` *'H •. `'"�1Ir�i,4B YAPeE.IAXy'R>AzN
� ti �i'mromm"'®r,"im
' Qhv�tili Stn ai�li`"Y.ri5.:, .:v?ii )' i[a+
�i�. �,nr�5�}r� MINE
�Q y 1,•'+V� �`_�lt'zF ,�,� ��1 j � j :^,.��,ja`�ji('��.t�"'`�j���� "r C(R��5�g� :;�kr c�L�'>y,1z�:�r1t1{ �1�y ����7 'ti�,�i inn 5r "��tl
`•mi�`:i_'1;I 'ctJ31a�:4t:4IMINEE
. _ Moor.
. ■Sewer Eleptic Building Height:_
a..{ .'1L'F:M1'r.. �, ,n.m. '{C^.fin.� >"k. '7'S'. �¢,F.7Q7" r,„•1+! 'i7' Mx!f '.� iS - ;1' ” '[u
i'���. le�°idil 'sF7n to r,�.e'1���rr�''''F ,P~,�. 4�1�� ) .j�•.�a 4 `�(' 1`f,•lt:T c ej�fl���'� � Ii bup'%�,7� r 4' ,i cp�yl A. v' ul
y,,{' 4•���\'%"."+ v [ � i� � '' rF� r .tl ,�i�� Al d•J •nt +� {� t� 1�j d�4. �•. f Nvj�Yy ra 7 11�°i. 1
'L:, . Lar4JF' ��1bEr)1������� � � �:�'�'d [��r',17i::, m si��•��' .y °" s� ,4, .0 r'�, i�i� ���,��^�
Name 011
Address At
04 iM
City
Zip
.. • �Ilr 1G11�>i
Phone
r r � 1 ��►
Fill in fee-51rnple Title Holder on nextpage
listedfrom the Owner above)
if value uf con.-&urction it or more,a RECORDED Notice of CommenceTnent is required.
1 1 • I
OCT-23-2015 FRI 03:29 PM CENTRAL SCHEDULING FAX No' 32126$6138 P. 003
r w'9 a r d,,!i�i� %a- n f ,; i 1, ;�r�. ,'tr 3 { ��, ay��N' n i
SAS�" ,1�'i (y4 .'�, MINE, + $« c
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: I Name:
Address: Address:
City: State: City: State:
Zip: -- — Phone: Zip: _ Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable 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 apermit will authorize the permit 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 dead for any-restrictions which may apply.
In consideration of the granting of this requested permit,I 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
comrnencin work or recordinglyour Notice of Commencement.
Signature owner/A tj Lessee Signature Contractor/LI rise Holder
STATE OF FL iPA STATE OF FLORIDAl�
CCIUNCYo COUNTYOF
The rgoing in t was acknowledge before me The f�r Ing ins rr ant was acknowledg d before me
this c day off �/ , __ Fby thls s�,r y of� ._'` ,�� }by
[cam.
(Name—of person acknowledging) (Name_oerson acknowledging)
r
(Signature of Notary Public State of F r 2). (signature of Notary Public-State da)
,Personally Known K OR Produced Identification Personally Known.1\ OR Produced Identification
,Type of Identification Produced Type of Identification Produced
{ r'r`: Catherine„ a>s er
4
Commission No ,Com>riissloR#.RF17 rnnlission N
_ I xptrres:OCT 2611 i
(4001 4- Ronger
: tOt7237
<• <.^aft'
and+` 1 ANnTQA 1=-
Revised0?!I5/Z014 ”' di " ciz�iY K}THRU,
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLF MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REViEW REV[EW
DATE
COMPLETI
INITIALS