HomeMy WebLinkAboutBuilding Permit Application I
ALL APPLICABLE[MFG MUST BE COMPLETED FOR APPLICATION To BE ACCEPTED �
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Date: 05f19/1f Per!nit Number: il, U OS- 03S4 If
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Build-ice Perm- it Applicatimn j
Planning and-Development Services
_ dg-ding_andLode.ReydiationD1vW1on
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (MY)462-,1553Fax (Mz)462--_.T578 ;Com mer-cial -Residential X
_ PERMIT APPUCAT[ON FOR: To Select from dropboxr dick arrow at the a id of litre
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Address..618 N Coconut Ave., Port Saint Lucie, FL 34952
=Legal-Description:-River.Park-Unit-2-BLK`l5-Lot-20-(MAP-34/22N)-(OR-3593-1.260)
propertyTa-i.+D-ft: 3419-510 t1-62 W4 Lot N a.
Site Plan Name: Block No.
'Project Name:
Setbacks_ Front Back: Bight Side: Left Side:
R MI'^ 5� ..-, Xp, I'C` C "{4^ P 111,1:,
.�}ft" ..Zp;.:. "t" 5� aYCf s `""i +.-
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Replace ulterior:door of night rear of home_ i
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CONST, (NFORMT(ONt ,
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A itipna work-to- e e: orme :under.l is,permit—c -ec all- apply: -
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014VACO'Gas Tarrk oGas Piping Shutters t/1/ir►dvvtrs/l?ovrs
011oof uElectxic 0 Plumloing [DSprinklers OGenerator
Total Sq. Ft of Construction: N/A S . Ft.of First Floor: N/A
Cost of Construction,$ 500.00. Utilities.. Sewer-[ CSeptic 6uitdiing Height:-
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f�1a,,e�+r''-�,pr�/I„z iia, :Louis Ceforla
Address:711 SE Celtic Avenue Company: Amant Homes of Florida, Inc.
-City,., ort.-SdintLudie :_State.FL _ _Address: 1-669:'SE.South-Aiemeyer..Cir.,-#106
Zip Code: 34983 Fax: City Port SaFrA Lug J State:FL
Phone No. f{��(� ��Z 1�X02- Zip Code: 349'2 Fax: f772)934-7333
772 224-220411
E-Mail. N Phone No_ ( ) l
Fill in fee simple Title Holder on next page(if different E-Mail: amantoffice@gmai,l1com
from the O viper li=_ted above; State or County License: Ri2282811738
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if value-df-construction-is$25DD-or more,-aREL'OMED Notice-afJComynencement is-required.
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City: State: City: I. State:
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SIMPLE i L it: �x Not ppli,-able 13ONDI G COMPANY: i i x NIofi Appl
Name: Name:
Adtl ress.: Address:
pity: -City:
Zip- Phone-- Ziix:: Phone: 'i
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F certify that no work or installation has commenced prior to the issuance of a permit. 1
St. Lucie County makes no representation that is granting permit 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.Prase co��sult with.your Horne Owners Association aid revi6wyouur deed far any restrict' ons Lvnich may apply.
In consideration tifthe granfing-dxtliis rP�uesteil.permit, da iaer�by agrEe#ba#i uaiiii,in all respects,.perform the work
-in amordance-with-the-approved-plans,-the-Fl rids-Building-Codes-and-St.-Lucie-County-A,mendments.
The following-buildingpermnit-applications-are-exemptf'rom-undergoing-afoil-c-oncar'rency�review &oam- -addition,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
- A�tNIMTO�i3W'iiiz�E : Your-failur-etol3ecorda�tatice-of-Commencement-may-result-in.your-paying-twice=for
Improvements to your property_ANotice cif Corrinnencenlent rrntustbhe recorded 21ihd posted.on the.jdbsite.
before the first inspection. Ff you intend to obtain financi g, consult with tender i Ir an attorney before
commencing-work or recording our Notice of Commencement.
_Sighaturebf Owrier/Lessee/fide4 Lessee/ Signature of Contractor/License Fioi er
The-forgoing.instrument was acknowledged Before me The f rgai�ag
instrument u�rneina t was ackno edged before me
this day of "-k 20 \,by this day of ►�1rt� 1'� 20 by
JILL Li
(Name of person acknowledging) (Name of person ackn
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(Signatu P 'ary Public-State of Florida} (Signature of Gtprfy P ! tate of F orida}
Personally Known__-OR Produced Identification _ Personally Known_-0i ProducedIdentifjcation
Type of identification Produced � Type-of Iden#--kation Rrodticed
commission o. mmission No.
• ' J LL PERGOLINI ,�• ;. JILL PERGOLINI
• e MY COMMIS
I -'s MY COMMISSION#FF917M
EXPIRES*September 14,2D19, .. EXPIRES September 14,20.49.
Revised 07/15./2014 _ - ui t�uero,aa rawaw a .. --
401 I� 0
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