HomeMy WebLinkAbout1512-0464 P.1
Dec 2915 05'05P 11,!5
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date. Permit Number:
RECEIVED
RIMINI 11 Building Permit Application DEC 3 0 2015
Planning and Development Services PERIN41TTING
Building and Code Regulation Division St.Lucie Counjy�FL
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1579 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of 111M
MIN-,
IN IN Iff a.
Address: q1q.60 'L
Legal Description:
n t2 'Y7
Property Tax Its#: Lot No.
Site Plan Name: Block No.
Project Name,
Setbacks Front. Back: Right Side: Left Side:
ggg g
- i ,
or L7 I!k-61 C_'2>0 V, -V 5
0-tAT
io t-k P 14.-76 !S Cn E 1C
X_
eck all t=apply:
HVAC �'` Gas tank ❑Gas Piping _D Shutters Windows/Doors
Electric Plumbing QSprinklers 0—Generator Q Roof
Total Sq. Ft of Construction: SFt.of First Floor: t_
Cost of Construction:$ Utilities:[]Sewer Q Septic Building Height:
p,
I Maw 101�a
ON
Wg
Name L-1 n&L YA er Name: �\Jln _�
goo5 Company:
Address- State: f;-- Address
City:
Zip Code: Fax: city: PT, !S4. We-U- State: S_
Phone No. D Zip Code: Fax:
E-Mail* Phone No. -1-7 —'g-7)
Fill in fee simple Title Hoider on next page(if different E-Mail:
from the owner Listed above} f- State or county License:-LAC,
if value of construction is 500 or more,a RECORDED Notice of Commencement is required.
p.2
Dec 2915 05:05p
QEStGNER/ENGINEER: µ ____Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Dame:
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.Lucie CountyY makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in contiict 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,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,
accessary structures,swimming pools,fences,wails,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 r recordi r Notice of Commencement
s
_Signature of Owner/Lessee/Agent Signature of ontractor/License Holder
STATE OF FLORIDA r STATE OF FLORIDA '
COUNTY OF VDRT 5+, LtXCA-e, COUNTY OF Flom- s4-, Wck-0.1
The for Ding instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of •D,10U_V r)be)( , 20 L zby this al day of -b.C•E"PM 20 175 by
D l m e
(Name of person acknowledging} (Name of person acknowledging)
x ���:�-�- ���:� � ��nom--' �-.�.�-.�... �•,�•�`��.._....:
(Si nature'ofi:Npfary#?ubiio-State of Florida} (Signature of Notary Public State of Florida)
Perscrrsatiy iG{NaWn% 'r. .OR Produced Identification Personally Known 1� OR Produced ldentifiG i io �.-
T'4i=0r if entifIca � d Type of ld n e.
�-
tr mtriis , _� NDA' llj MY CdMMiSSiOV#FFi
sion14R i�lCHARD Commissi
, = aMMJSsiG1N#FF1 g �Y 21,201$
>;XP1AES M 2552 (407)M-Of53 FioridallotaryService•com - f
FtoridatJotaryservi f
Revi�sec'V r2014 .00M -:
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE NIANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS