HomeMy WebLinkAboutBuilding Permit Application 08/23/2017. 14:42 7724663737 BOYLEAC PAGE 01
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ALL APPUCABLE INFO MUST Of COMPLETED FOR APPEICATION TO BE ACCEPTED
Date:
Permit Number:
Building Permit Application
Planning and AevelopmentServlCes
Building and Code Regulation DlvLdon
23W Virginia Avenue,Fort Pierce FL 34987
Phone:(772)462-1553 Fax:)772)462-1578 Commercial .-- __.-- Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end,bf line
PROPOSED IMPROVEMENT LOCATION:
Address: / l '3hq5
Legal Description: S()QY1l .h IAWS I([A 10 LIL r _ _--
Property Tax
ID#: l30 0� � l -O�q g���1 _ Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front_ Back: Right Side: Left Side:
r DETAILED pESCRIPTiON Of WORK: .
`'1�k� �� Ula¢,.,:�'ns�l n�,iu Lerinax a.s "�Dn� �5 s�r✓� I�la1, � Kw h2
CON UCTION INFORMATION:
jr na woe to orfs under is permit—check a appy:
HVAC GasTank Gas Piping Shutters ;Windows/Doors
Electric Q Plumbing Sprinklers 1:1 Generator LI':Itoof
i
I Total Sq.Ft of Construction: .Ft.of First floor:
I IWO,,IJn�
Cost of Construction:$ rO,Q O Utilities: Sewer U Sept rc g uilding,Height:
OWNER/LESSEE: CONTRACTOR:
Name Name ID
Addre Company: { cod
City: 'l State: Address:
Zip Code: 5 Fax: WA City: f(P✓ -- - 5tate: L
Phone No. N Zip Code: 3 rJ 4 ---_ .Fax
E-Mail: 1A Phone No- -77 _---
Fill in fee simple Tide Wilder on next page(If different E-Mall:
from the owner listed above) State or County License: l l
N value of construction is$2500 or more,a RECORDED Notice of Commencement Is reptiler:d.
f'
08/23/2017 14:42 7724663737 BOYLEAC PAGE 02
SUPPLEMENTAL CONSTRUCTION ITN LAW INFORMATION:
DESIGNS NEER: _Not Applicable MORTGAGE COMPANY. _Not Applicable
Name- Name:
Address: -- Address:
City: State: City: -State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TrtLE HOLDER: _Not Applicable BONIXNG COMPANY: Not Applicable
Name: Name_
Address: Address'
city: city:
Zip: Phone: Zip: Phone: _
I certify that no work or installation has commenced prior to the Issuance of a permit.
St.Lude County makes no rep=tion that Is granting a��eermR will authorize the permit holder to build the subject strtrRure
which is In conflict with ahy app a Nome Owners As3ociation rules,bylaws or and covenants at may restrict or prohibit such
st1'ucture.Please consult with 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 1 will,In all respactx,,pefform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucle County Amendments:
The following building permit applications are exempt from undergoing a full concuftw"review room additions,
accessory structures,swimming pools,fences,walls,signs,screen morns and accessory uses to another noniesiderrtial use
WARNING TO OWNER:Your failure to Retard a Notice of Commernemelnt may result lit-Vow paying bdm for
Improvements to your property.A Notice of Commencement must be recorded and posted on theiobsite
before the first inspection.If you intend to obtain financing,consult with lender or an attorney before
commencinsE work or recording our Notice of Commencement_
Signature of Own Signature of Contracwfter&Halder
STATE OF FLDfflnA STATE OF FLOIIIDA
COUNTY OF COUNTY OF . .. ...... __,_._------
The fogrng i ment was acknowledged before me The fo Ing In ment was admowledged before me
thisary of 20�by this °f U � "
1"1 C°1`' �l�cam.( �Boyle., c-1 �
i t�So -
(Name of person acknowledging) (frame of person; edging)
atnre of Notary P tabe of Florida) (Signature of Notary tate of Florida)
Personally Known AR Produced Identifitaabio Personally Known OR Prod 1
Type of Identifies0MIJI 'type of Id
\11 Y P�I
P law M itMflhl Commission flelrry Pu1r8c•81�(!of k 1
WI
Commission No. g Cormml 1 d11011gi! Ir¢fgn*bid t�
My Cemm.Expires Avg 21,2020 My Comm.Explrrr Avg 21,11140
Revised 07115
RFV1EW5 FRONT ZONING SUPERVISOR PLANS V£c,mirtdN SEATURTI-E MANGROVE
GAUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
IN"1ALS