HomeMy WebLinkAboutBuilding Permit Application 08/03/2017 12:08 7724GG373,7 BOYLEAC PAGE 01
All.APPLI LE NFO MUST BE COMPLETED FOR APPLICATION To Of ACCEMD c�
Date: Permit Number.- 161 c)d o5
- - RECEI`'TT AUG 03 201/
building Permit Application _
Planning and 0�eve/opmentServlaes
Building and Code ReguhWan Dh*jon >>
2300 Wrginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: Wft&(J& kpin M- 61
-
Legal Deselption4 kf w
Property Tax iD il:_-�_ �� .�aa~��• [ "�♦7Q ----- Lot No.�
Site Plan Name: Block No.. . _
Project Name:
Setbacks Front Back: Right Side:---- _. Left Side:
DETAILED DESCRIPTION OF WORK:
Ss�tw/1•5 hIak
n Mode1 #-9A1tP30AT1lQA XtrHwdI&rNod4t(4�p,RIP3oi-1srANTA
CONSTRUCTION INFORMATION:
-51-Additlo wo a orme under t permit— ec a appy:
VAC Gas Tank []Gas Piping Shutters Windows/Doors .
LIElectric Plumbing Sprinklers 1:1 Generator C1 Roof
Total Sq.Ft of Construction: _ Ft.of First floor:
Cost of Construction:S � Q• Utilities:0Sewer USeptic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Name:
Address: g Gnmpany- N1r I
City State:,� Address: 5105'A TUYA 'Pl I:, fr er
• T
Zip Cade: Fax City: ,itlrc - _ _state:
Phone Na.-M21 514gi '1172 Zip Code' qqSJ
E-Mail: Ph a No.3161,Q1,11
Fill in fee simple Title Holder on next page(if different -Mail• *NEW
from the Owner listed above) State or County License: CArL� I$l8 (4
if value of construction is S1SW or more,a RECORDED Notice of Commencement Is requh el.
08/03/2017 12:08 7724GG3737 BOYLEAC PAGE 02
FFEE
PPLEMENTAL„CONSTRUCTION LIEN LAIN INFORMATION:
iGN NEER: Not Applicable MORTGAGE COMPANY:
----------------
e. Name: Not Appltcalble
rRss: Address:
City• State-
._Phone• Zip:—. Phone: -
SIMPLE TME HOLDER: Not Applicable RONDMG COMPANY:
Name: Name-
Not Applicable
Address- Address.
City: may.
Zip: Phone: ZIP: Phone-,
I certffy that no work or installation has commenced prior to the lssuance of a permit
5t.l�icie Gourrtlr makes no rapreserrtation that is granting a permit w11t authorize the holderto build the subject sfauchire
which is in conflict With arrl( pplicable Home Owners oc�aUan rules,bylaws or and covenants that may restrict or prohibit such
structure.lNease consult wrt�i your Home Owners Association and review your deed for any resbri um which may apply.
In consideration of the granting of this requested pwmk,i do hereby agree that 1 will,in all respects,perform the work
in mew dance with the approved plans,the Florida Building Codes and St Lucie County Amendments.
The following building permit applications are exempt from undergoing a full roncurrancy review:ram addkkm,
accessory structures,swImming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your 1TWure to Record a Notice of Canrnereeerrlent nary ra4dt In your payft twke 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
commendnI work or recordin our Notice of Commencement.
Sign re of Oven Agent/ re of Contracm Alconsm
SPATE OF FLORIDA r SPATE OF FLORIDAI
COUNTY OF COUNTY OF LW
i11e fo I mens was acknowledged before me The=instru ent was admowtedged before me
this of 20 Wby this of 2Q_„ rbry
MSG eE . PJU rz W( el f60
(Name of person adcnowiedgf ) (Name of person admawi ng j .
a-nz—/-Z�
(Signature of Notary bliic State of Florida) (Signature of Notary � tabs of Florida)
Personally Known V OR Produced IdenEflpatian Personally Identification
Type of Idantiicatign�i� lVpe of
All
Notary Public State of F1011na
Notery Public-stillI
Comm on r GGOW09 � Comm Ion.M 00
My Comm.Expires Avg 21,2020 My Comm.Explren Aug 21,20,20)
oll Wool Nelary As
REvwd 07/15/2014
REVIE1Ws FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURW MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
08/03/2017 12:08 7724663737 BOYLEAC PAGE 03
RECEN'=D AUG o,3 2011
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