HomeMy WebLinkAboutBuilding Permit Application 10/06/2017 03:33 7724663737 BOYLE PAGE 01
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ALL APPUCABLE I FO MUST BE COMPLETED FOR APPUCATION To BE ACCEPTED I
Date: Permit Number:. 1� �I . 0 I
RECEIVED
Building Permit Application OCT 0 6 2017
Alarming and Deve/np wnt Semkos - -
Building and Code Reguk tOn Vvision PEZ1 ,123W VirginiaAvI�J w,FIn ftm FL 34982. � St. Lu , FL
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the and of line J
PROPOSED IMPROVEMENT LOCATION:
Address: SO 51
Legal Description: ISO I�-,A1�Q� �{G.�1.5 B►ti�}' I.Ort —
Property Tax ID#: NX-10(-06 A 2 0,00 3 Lot No.
Site Plan Name:. Block No.
Project Name;
Setbacks Front flack: , Right Side: Left Side:
DETAILED DFSCRIPInON OF WORK:
kkL - IWI new 4 Ion I SaA ufiorx.At G P"&
turlj� ui0 10 kW
CONSTRUCTION INFORMA-nON:
Adgitlow work to Torme under s perm —c e a appy:
VAC Gas Tank . as Piping Shutters Windovrs/Doors
ClElectric o Plumbing Sprinklers O Generator Roof
Total Sq.Ft of Construction(: q .Ft.of First Floor:
Cost of construction:S 9 000.00 Utilities Sewer o Septic Building Height:�
OWNERAESSEE: CONTRACTOR:
Name Name: WA 0
Address.-!i
ddress: Company: ,
city innmi ----- 5tste: Ad 1..- 510
Zip Code: S 31 it B Fax: H City: B cxtf State:rk,
�l
Phone No. 305.`7a(D�'L7 —] Zip Code: " Fax: 11�L iek-9-131
E-Mail: NIA Phone No. L
Fill in fee simple TWe Halder an next page(if dHferent E-Mail: �boyloM_P_a t#-
bam the owner lbted abom) State or County License:
N value of anuli ethm is 52500 or nwre,a QED Noticed Comawncement Is required.
10/06/2017 03:33 7724663737 BOYLE PAGE 02
SUPPLEMENTAL CON5rRUCTION LIEN LAW INFORMATION:
Name: ^-- Applic ble �COMIsARY: Not Applicable
Name:
Address: Address;
State: City;
Zip: Phare• Zip= �Phone:
FEE SIMKE TITLE HOLDER: Not Applicable ROIIWIN6 COMPANY. Nat Applicable
Name: Name:
Address- Addrew•
��P',.,». . Phone: _.—- Ori►'
f txrtlfy drat no work ar h>�lHntfort has antranettced prior to the isst+anar of a Isertnit-
5t- rlo that Is gra a yy�u the m build the subject
which is in cal tt�e a e!fame Ow�1011G�ai rfS�ara� t a �
structure.Phase consult th your"we Owners Association and rrs*Av your deed ant►restrictitlns which trnly apply
In o4n0derntion of the of Ods requested Wrnftr I do hereby uiiree that l will,in aA respects,perform the work
In accorderwe vA**e apWoved plans,the Florida BuNding Codm and St:Lucia County AmerWmants.
TM fallawft holt tB Pwird appkatk a are exempt from undergofrta a fun eo mwff envy rleAM..morn additions,
accessory SMKWM swhrllrting Po*hmce%wak*M,summ"arm and atxr my Ufts to another nwmeddendal Lm
WARNM TO ONINER:Yew tak n tw Itaoord R Naive of Canweam emelllt rntitn►result in vola Pav ft Uvkv for
improvements to your property-A Notice of Commencement must be recorded and p* ted on the Jobske
before the first inspec Ott If you intend to oWin.flnancinR,consult with lender or an attorney before
commencing work or recording r Notice of Commencement
signature Qf orrtelr signature of contrecoar/Licanae Flolder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF COUMY OF__.__ [Q/
The Ding m was mad before me The was adoipwledned before me
tFtts�".day of ]A 3K by this
of nt 20_.id by
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(Flame of person adtnw&1eVna)T' (Noma of perasaott aciatrrwledging� .
(Signature of Notary State of Florida) of kola stag of Rod&l
Personally Known OR Produtwd d Pars afh►Knonwrr OR Produrod Id bion
Type of Ideb �tlRls ftNE � a 1ww ur
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW. REVIEW REVIEW.
DATE
COMPISTB
INITIALS