HomeMy WebLinkAboutBuilding Permit Application 08/28/2017 11:03 7724663737 BOYLEAC PAGE 01
ALL APPLICABLE INFO MUST BE COMPLETED FOR AppLICATION TO BE ACCEPTED
Date:
wo
Permit Number:
� ' , a
Building Permit Application
R EC E li/E
Planning and DevelopmenrServices pp AUGQ �fM
Building.and Cade Regukalon Division A 2 8 Lu F7
23001<rginia Avenue,Fort Pierce FL 34982 P E , i TTI NG
Phone:(772)462-1553 Fax;(772)462-1578 Commercial Residential St: ole County; FL
PERMIT APPLICATION FOR: To Sl3leat from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 3a1 I
Legal Oescription
Property Tax ID tl: 1304 (PIA "Qj�9 —000-0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks FrontBack: Right Side: Left Side:
f�ETAILED DESCRIPTION OF WORK:
l,il�Q 46� Ok&: -M' Stal I nww I,Q17rM A:s toy, .14,serer- c 5FI14- SfXrrn whpl
CONSTRUCTION INFORMATION:
Ad
clitim-Uh-alworKtobellerformed under MIS permit-check ail apply:
HVAC Gas Tank []Gas Piping Shutters E]Windows/Doors
Electric LJ Plumbing Sprinklers Generator Roof
Total Sq.Ft of Construction: Ft.of First Floor:
Cost of Construction:$ 3�W„• -_- Utilities Sewer[]Septic Building Height: _
OWNER/LESSEE: CONTRACTOR:
Name l Name:
Address• i Company: M`
City: r State:Pt, Address: 50-
Zip
0 Zip Code: City: &TFIOrre, State:R
Phone No. -51q7 Zip Code: 5 JA 5 Fax
E-Mail: N A- Phone
Fill in fee simple Title Holder on next page(if different E-Mail-
from the Owner listed above) State or County License:
If value of construttlon Is$25W or more,a RECORDED Notice of Commencement is repaired.
08/28/2017 11:03 7724663737 BOYLEAC PAGE 02
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNS NEER: Not Applicable MORTGAGE COMPANY: ' Not Applicable
Name: Name:
Address: Address:
City: -------City: State:Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE BOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name.
Address, Address:
City: -_ Cfty:
Zip: Phone: _... rip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lude County ma no no repr qrt that Is granting a permit II orke the permit holder to build the suistect s uture
which Is In eonfllct with anr�yy applicable Home oYmers Association es, aws or and covenants that may restrict or p. 1 such
structure.Please consult vM your Home Owners Association and rrAw your deed for any restrictions which may apply.
In consideration of the graining of this requested permit,l do hereby agree that 1 will,In all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The f Dowing building permit applications are exempt from undergoing a full concurrency►review.room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Yater faihtre to Recratd R1 Native of[a— CTICO WA may FWAA fin-youIr Paft twke fiat
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 or recording y2ur Notice of Commencement.
Signature of Own ent/ Signature of Contractor/Ucense Hold
STATE OF FLOR STATE OF FLORIDA
COUNTY� COUNTY
The fomoina i mans was acknowledged before me The f��was acknowledged before me
this le day�s , 20 � by this of £, .20�by
i� t�v
(Name of person acknmW ng) (Name of parson ging)
49WILIL + dXUazt_--1
(Signature of Notary I State of Florida) (Signature of Notary of Morkla)
Persiolt cl ; Haimon Personally OR Produced Identification
Type of r le Type of We
Comm My Cetatn,EMpk1e AYI"MORRO No"�d com mWoon NNKy Pt11110-a �
M ` kebn.N i>M
Mei Cemm,Expires Aug 21,2M
Ikeviwd 07/15/2014
NEViEWs FRONT 20NING SUPERVISOR PLANS VEGETATION SEA 1rURTLE MANGROVE
COUNTIER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
08/28/2017 11:03 7724663737 BOYLEAC PAGE 04
IWM ENERGY CONSUV,A TION CODE
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and bcafdtwlth tlMA raqub+unemsr d 1Q1.�.7.t.1 as indked belvws
Where need:,
th!e�dettnj ducbt twee b+eaa seal■d r�rebdWced tt -dr aircoda
qpmvad a**valvM
o Ductx xv*hx OW within erxuNdom spies.(9.r.M on tWA7 l X111)
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o 9pwmwwtmftd(s"below)wd repairsrwr� es.necswuey–(tb e.n
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I MOW 1 have te,gat I the r place air ll%w wM rg$)raft" IV,"pefilm ttsM■d abeam at
a pf"Mm elflMb v Wl of 25 Pa=k W.w.&I