HomeMy WebLinkAboutcarltonALL APPUDARE ileo MUST DE C0RQBDLnw (FOR A(PPLUCWJG% To M[E Ac CEPVED
Perr`Aat Number:
Date:
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Plerce FL 34.82
Phone: (772) 462-1553 Fax: (772) 462-1578 VncarcIa
I PERMIT APPUCA ION FOR: ` 0 ,9e1@ct from dropbmz, clack grow at the and of line IN
Fc OP SED h PROVEM NT LOCAT IMM : _ 1411
Address:
Legal Description:
Property Tax ID g: _ a3 I cc -o-5'- owi •- 1 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: might Side: Left Side:
DETAILED DESCRIPTiOii , OF VgorjV�;
Name c. c d
Name: c .
Address: 1() L(g S '37 S
Company: " i 4'.r h �
City: t t -State: #=
Address: Ole,.z J ee mac- ,
Zip Code:Lf 9 4 7 Fax:
City: State: •rte
Phone No.
Zip Code:Fax: ( i ~?
E -Mail:
Phone No. L G+ '/— � 8�
(fill in he simple This H@fldar &n neat tgagct d oq dafflgm[mt
E-Mail:I- � �.+nc� - %n�' l a
CONSTRUCTION IHFORWTION-.-
State or County License: C A -G 1 5 3(o ll
Additional work
rme uner t IS permit-- eC
OGasTank Gas Wiping
anapply:[DHVAC
Shutters
Lj Windows/Doors
Electric
i ~4 Plumbing [3Sprinkiers
L
Generator
Lj
Roof
Total Sq. Ft of Construction:
Cost of Construction: $ 1-16 o
Sq. Ft. of First floor: _
Utilities Sewer Septic
Building Height -
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Name c. c d
Name: c .
Address: 1() L(g S '37 S
Company: " i 4'.r h �
City: t t -State: #=
Address: Ole,.z J ee mac- ,
Zip Code:Lf 9 4 7 Fax:
City: State: •rte
Phone No.
Zip Code:Fax: ( i ~?
E -Mail:
Phone No. L G+ '/— � 8�
(fill in he simple This H@fldar &n neat tgagct d oq dafflgm[mt
E-Mail:I- � �.+nc� - %n�' l a
f o��u tG�e a4' nelF
State or County License: C A -G 1 5 3(o ll
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Naame:
Address:
City: State:
Zip: Phone: —
FEE 99DAPLE TOME Gd1OLDER' ® Not Appkable
Name:
Address:
City:-
Zip: Phone:
G�v�i OGa3iP�r�GI� QO����C��o
Name, ° �
Address- _
Address-_
City:� -State,
zip: � -- phone'. -
WHOING Cay, NINMY'. ��. Not Applicable
Name,
Address:-
city: -
Zip: Phone -
I certify that no wort( or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the ermit holder to build the subject structure
which Is in crs ict with any applicable Home Owners Association rules, bylaws or an covenants, that may restrict or prohibit such
structure. Please consult wrath 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 wilding Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency reviews room additions,
accessory structures, swimming pools, fences, walis, signs, screen rooms and accessory apses to another non-residential use
PJARNONG TO OPMER.- V@yap ffanum to G,,(@c@rd 61 p�oggG d C gvn ins enem mmnt M@y pGgulC qR V@orf P'%VMS tMlce for
improvements to your property. A Notice of Commencement musty be recorded and posted on the jobsite
before the first inspection. l'ff you intend to obtain ffinandng, cansult with lender or an aitomey before
commencing work or recordina, yokir MOUCe Of Commencement.
Si tore of owner/ lessee/AgentS tore of Cantractor/F rise Hoiden
SIMSG OF FLORMA
®M `� fl-i� C7O ✓''1 c..c ° e-_ COUG`rM OF 1 it C
The forgoing instrument wat acknowledged before m42 The forgoing Instrument was acknowledged before nee
MOL day of .rU��, rn �e.r� . 21! S' by this day of �. �z •�►� �t . 20 () by
V1 LJ r} rZ -' c X` �= .� Li %= _1__)(Name person acknowledging) (Mame of person acknowledging)
(Signature of (Votary Public State of Florida 4 � (Signature of Notary Public- State of Florida i
Personally Known OR Produced Identification
Type of Identification PrtsdLwarl---
Commission No..
Revised 07/15/2014
MORIP46k - no *#W
Commission • FF 216WI
Personally Known OR Produced Identification
Sype of Identification Prod --L - - - - _ - _ -
Ho•A° NW • bests o1 FM
� � �= Coawah" #f FF 216$91
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