HomeMy WebLinkAboutBuilding Permit Application 06/09/2017 12:33 7724663737 BOYLEAC PAGE 01
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rALL ApPUCA LE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEP O
Date: RECEIVED JUN 9 9-2017 Permit Number:1113 1-O a3a
Building Permit Application
plannfng and Mvelopment Services
Building and Code Reguiolon DIWWn
2300 virginla Avenue,Fort Pleme Ft 3402
Phone:(772)462-1553 Fax:n72)462-1578 Commercial Residential. V/
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line v C
PROPOSED IMPROVEMENT LOCATION:
Address: ( NVA. fg1latAUL
Legal Description: irr 00A BA -i Milk 77 8L IG-1-7 10
Property Tax ID#: t l Dy D I a>� --OOD Lot No.-
Site Plan Name- Block No,
Project Name-
Setbacks Front.._-__ Back: Right Side_ Left Side:
11'D�#ErrAILED DESCRIPTION OF WORK:
u� Ir. kW LI. r•e a•5 n Ifo si�i fe. roc sq wrfh
7
�wm. Con*w 90PA f-I4ANS 030-M) LP, vlcy,Ar�W[g 2
CONRMATION:
Addit Orme un er s perm �c e a appy:
T"HVACGasTank Cas Piping Shutters Windows/Doors
11Electric Q Plumbing ❑SprinklersGenerator Roof
Total-Sq.Ft of Construction: 1 ' Ft.of first Floor:
Cost of Construction:S 3� 0• Utilities Sewer 1JSeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name V Name-
Address• LoD company:
City: State: Addres :Jt- 0 A:
Zip Code: Fax: City:
Phone No. Zip Code::Mg5t Fax:
E-Maii:_N Phone No. -
Fill In fee simple Title Holder on next page{It different E-Mail:
from the Owner Ilswad above State or County License: �I
It value of construction Is$2500 or more,a RFCORMo Notice of Cwnmeneement Is mquired.
06/09/2017 12:33 7724663737 BOYLEAC PAGE 02
SUPPLEMENTAL CONS'T`RUCTION LIEN LAW INFORMATION:
DESIGNS NEER: _Not Applicable MORTGAGE COMPANY• Not Applicable
Name: _ Name:
Address: -- Address: _.
City State: City: __ $tate: .�.
Zip: Phone: zip: - Phone:
FEE SIMPLE TiTLE HOLDER: Not Applicable 80NDING COMPANY- _Not Applicable
Name: Name-,
Address. Address:
City: City:
Zip: Phone: zip: Phone.-,
1 certify that no work or installation has commenced prim to the Issuance of a permit.
TE : It
Coimakes norepthat Lsgmwh5 htt with any�pbe Home Ownstrre. oonsuR with ur Home Owners AsSaduion and review your deed any resp lotions which may app
In consideration of the granting of this requested permit,i do hereby agree that 1 wtll,in all respects,perform the work
in aawdencae with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The fallowing building permit applications are exempt from undergoing a full concurrenry review,room additions,
accessory structures,swirrm+ing POOLS,fences,waltz„signs,scrmr rooms and accessary uses to another mai use
WARNING TO OWNER:Your faikme to Record a Notice of Commencement may rewh to Vow pa Vkg twi*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
commencing work orrecordingour Notice of Commencement.
00
Signature of Owney Agwy Lessee Signature of Contractor/tkense Holder
STATE OF FLORIDA STATE OF FLGRI �
COUNTY OF -Nt. b COUNTY
The faing lnstru eM vras gcknawledged before me The forgoing instrument was acknowledged behpre me
this day of 20 19 by this U day of LAN P .20-A by
i"I c4r-- I'T ayt�
(Name of person acknovrl ng) (Name of person ng)
(Signature of Nota -State of Florida) (Signature of Nota u o-State of RoAds)
Personally Kn Othi�on Personally Kn
Type of Iden y IMe of NWOMMI Type Of Id
p�i IT4 ' "' ►il irttre�t Tr p
Commission A 'Comm;Explr 1,X040
MCommissiony Comm.Expi Tl,2D20 0
11rifHouphM�bl l�il' WougnNn n Ir�A/1n.
Reel ed 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURT1E MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE . .
LINrMnALS
06/0912017
2017 12:33 7724663737 BOYLEAC PAGE 04
in/in
RECEIVED JUN 0 9 2017
nOMIDA ENERGY CONSUVATION CODE
Mandatory Duct InspeW913 CerdamtJou of BVAC Okmge-aut
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we no 0 to
appnmW equk*Wft
o Duch ism 16cond within im"diiftd Wm-(s"On IMA-7.1 mc"dw 1)
o The jofrft at seams am sdres*s6aIW wit labile and mastic(Section ICIA71.1
em, ptim 2)
o
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