HomeMy WebLinkAboutBuilding Permit Application 08/25/2017 11:51 7724663737 BOYLEAC PAGE 01
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ALL AMI LE IN O MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED /
Date: Permit Number'. I I
Building permit Application
Planning and Development Services
Building and Cade Regulation Division
2300 Virginia Avenue,Fort Pierce FL 3498.2
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR; To Select from droPbox, click arrow at the and of line
PROPOSED IMPROVEMENT LOCATION: �
Address:
Legal Description: _ �Wad Vat L(A_61 q 51 �19 . � Iq
Property Tax lD#i: _�, ( '�P +~p�0 4 - Lot Na.
Site Plan Name; Block No.
Project Name:
Setbacks Front ; Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Y1LUVRUu.D 3 foh 1& S 0E C ��Sfizn� �u i
�.� KW ural.
C,�mdl1 CVlodP,l 4-RA 143( kI NA
CONS LICTION INFORMATION:
IT ' na wor d omme under perm W ec a apply:
HVAC 13 Gas Tank ❑Gas Piping _Shutters [IVA ndows/Doors
OElectric U Plumbing OSprinklers Generator Roof
-total Sq.Ft of Construction: �ry Ft.of First Floor.
Cost of Construction:$ t Q Utilities Sewer Ej Septic Building Height:
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OWNERAESSEE: CONTRACTOR:
Name Name•
Addre : Company: 171
� I
City: j State. Address
Zip Code; Fax: City: ,SttM.
Phone No. .41 Zip Coder Fax: :�OI .� ?3'7
E-Mail: Phone No.
Fill In fee simple Title Hodder a next page(If different E-Mail:(013��ae ,"Do.CAM
n
from the Owner listed abovei State or County license:
If value of construction is Szsw or more,a RECORDED Notice of Commencement is requlmd.
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08/25/2017 11:51 7724663737 BOYLEAC PAGE ' 02
[Zip:
PKEMENTAi,CONSTRUCTION LIEN LAW INFORMATION:
SIGN ENGINEER: Not Applicable
me: MORT6AC CdMPANY.- _Not Appf iratble
Name:
dress- Addres`s-
: State:
zip: --. fiftone: ._ -
Zip: Phone: State:
E SIMPLE I NOI.DER: Not Applicable BONDING COMPANY:
Not Applicable
Name; Name:
dress. Address:
y: _ city:
Phone. _ ,.,. -- Ziff: Phone;
i certify that no work or Inoallation has tummenced prior to the issuance of a permit,
SL a Cou�y makes no rep on that is granting a it will authorize the permit haler m build the subir
which!n tanflit t with ar�y apps Home Owners Assoc on r ulm bylaws or and covenants Viat may restrict or pl phibit sudr'
structure.Please consult with your Home Owners Association and review your dead for any restrictions which may apply.
In consideration of the grarting of this requested permit,t do hereby agree that i will,in all rawed%perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucia County Amendments.
The following building permit applications are exempt from undergoing a NO concurrency review.room additiom,,
a=Sstiry Structures,swimming pools,fh•t cM.Wails,signs,screen rooms and accessory uses to another non.-residential use
WARNING TO OWNER:Your failure to Record a Notice of Cant+nertcet»ent nwf rawkin your pet twkoa for
Improvements to your property.A Notice of Commencement must be recorded band posted on the jobsite
before the first inspection.If you intend to gain financing,consuls;with lender or an attorney before
commencing work or recording your Notice of Commencement.
Signature of Ag Signature of Contradw/Ucehse f lolder
CCDUOF FO rf COUNTY DFSTEF °A
The
ng 1 meat WAS admovwtedged hefore me Thefb meat s acknowrledgled before me
this day of ZO chis of !I Z0 by
NL►` e�y � o I�
(Name of person admowledging) (Name of person admawl °ng)
(Signature of Notarybliv-State of Florida) (51g1rdture of Notary7"aR
tam of Florida)
Personally Known OR Ilmduced ide�on Personally Known Produced Identification
Type of Iden Merl Type of W
Cltllftirtlllk, . '"C"Pi#TiNE d.CONWFLL
Commission N y 1! CommissioefaMsWim
Not! Public-81�I&t
_. commission 0 017 #Y
COIIMMreton ht rig D1I#7#
:� M I omm.Ex ►fee Aug21,2020
60�drdthrough NaliCnal try
��'�° �� Bonded iMoupn Nat' A'Maury Aim,
Revised 07
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW RE111IEW
DATE
COMPLETE
INITIAIS
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