HomeMy WebLinkAboutApplication & drawingALL APPUCABLE I
F ]BE COMPLETEDFOR APPLICATION TO 6E ACCEPTrin
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Permit kir,
Permit Atpp�itaiBuildinpnr�
Plornneng and f)euelnpnaent Services
Building and Code Regulation DiVisian
2300 Virginia pveriuej Fart Pierce Ft 34982
Phone: (-772),462-1553 Fax: (772y 462-1578
Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 101 8iaC I�
Legal Description: W 'S ,s f � f�j f k. (j (.pr ;j C7
Property lax ID #: 3�03.0_01
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VntntI(t/ -7
Site Plan Name: H 6 1 com (9 Block No.
Project Name:
Setbacks Front Back: -S_ffi� Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
i vl547,Ll( (G ' llrg l� wac� .tea?CSC t -4oCL M ej`<
Alwtc� �'t�te vear Proms -!y tL�. 6*wGh=Y�q-ry il�P {r:,o�+ car✓izrs u� ��k
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CONSTRUCTION INFORMATION:
Jdrtional work to he erformed
1HVAC L.1 Gas Tank
Electric � Plumbing
under this permit — check a
lGas Piping
[]Sprinklers
app
Shutters
Generator
ElWindows/Doors
LlRoof
TotaISq- Ft of Construction: S Ft- of First Floor:
Cost of r tru ti I iti� Sewer Septic � � N ding Height:
OWNER/LESSEE: ,
Name GQ C0+�1 0
Address: _1 �.l ,dretG
City: Y State•
Zip Code: 3q!Z E r�'� - Fax:
Phvne No. 15 7'' 5'10" 8-7 5740
E -Mail: 6kovib hdel 4ahcottCom
4-2-4
Fill in fee simple lute Holder an next page ( if different
from the Owner listed above)
Name: 1'" d cyl C V11
Company: 0 1 1 LkVIz•'! f'7 � 1l� C
Address; S if � � �� k_V) i -
City: _T ��- _ _ Stater
Zip code: ,3`�q�� Fax: YD
Phony No. i2LI V
E -Mail: LtgA2za^0 ko C
State or County License:
if value of construction is $2500 or mor ,, a RECORDED Notice of Commencement is required;
111
SUPPLEMENTAL TRU ION LIEN LAW I NFORMATION10
DESIGNER/lENGINEERS
Not Applicable MORTGAGE COMPANY: Not Applicable
KU I Name
-
V
Address: Address.
City: State., City:
Zip: Phone-.-_ - _ Zip:
.. ------- Phone;
FEE SIMPLE HOLDER of Applicable BONDING COMPANY: Not Applicable
Name:
Address: Address.
�-
Zip: Phone. 1.r
i certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Cour makes no representation that i raMntin a 3r it will authorize the Serm it holder t build the subject structure
tincovenants that may restrict r prohibit such
which is' � nth any appir �l f�� � r��r� c�+�rartr�� rul ,� bYi���rr �r a
structure. Please consult with your Home Owners Association and revir your deed for any restrictions i�h al+
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 pians., the Florida Building Codes anid St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures,, swimming pools, fences, +T alls,, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your faifure to Record a Notice of Commencement may result in your paying twits 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
cvmmencine work or recording your Notice of Commencement.
Signature of Owner/ tesseehQent
STATS OF FLORIDA
counrnr OF
The for�ga,['�r�g ins#r meat was acknowledge, before me
this�iay of� 20 _[�_hy
(UCSF persol acknowl6clging )
(Sigpffur44NotaryX'Pubfic-State of Florida j
Personably Fnown OR p
Type of identification produced_
Commission I
Revised 07
0q1, 6'P:+1r+'r.0�
201*`
Identification
ignature of Contractor/ucenje HWer
STATE OF FLORIDA)
COUNTY OF-
The forgoing instru� epi was acknowledged before me
this �ay of 20 � by
(Name of person a
turetbf Nota
Personally Known
Type of i�lA. ~
MARYA #TTEO commi!
Notary Public - State of Florida
M
I soil # EE 819074
Sundel Thi 009h Nationa i Noclaf y Assn,
nowledgang )
5
P
Public- State of Florid ) - -
OR Produted Identification
dacjM L�'
MARYANN BATTED
Nolary Public * SjaLte of (Wal)
Oen. Expires Aprr t
=MMS S ion EE 8
fOugh NatiOnal Notary s
I
MANGRowE
REVIEW
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