HomeMy WebLinkAboutBuilding Permit Application � III
02/06/2018 03:29 7724663737 BOYLE ! PAGE 01
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ALL APPL INFO MUST BE COMPLETED FOR APPLICATioN TO BE ACCEPUD
Date: Permit Number• spU2 • (�l3
Building permit Applicatio
Planning and beveloprnentServices
eulldlhp and Cade ReguhWon Alvlslon !'j
2300 Virginia Avenue,For!Pleme FL 34982
Phone.02)462-1553 Fax:(772)462-1578 Commercial� Residi ntial
PERMIT APPLICATION FOR: TO Select from dropbox, click arrow at the end'Qt line
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ription: 4L
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Property Tax lD#•
Lot No.
Site Plan Name: Block No.
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Project Name: ,
Setbacks Front Back: Right Side: Left Side: j
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5ta.Ll.yltw`.4;5 -brl 1 5 6I >~ RUAb A/0,r System w 7k W
COY( Olser MOdd # IR 1413051N)�,� Air Nrdtr Modz( RK4 Sol-JsrAW
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I na wo rformed under this perm —check all appy:
HVAC Gas Tank 0aas Piping Shutters Windows/Doors
Electric [J Plumbing Sprinklers Generator Roof
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Total Sq.Ft of Construction: ,Ft_of First Floor:
Cost of Construction:$ %00-00 UtilitiesSewer Useptic Building(Height:
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Nage ° �/•
Mame:
Address: Company:
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City: State• / Address•
Zip Code: 4r51 Fax: NIA City. 11, State
Phone No.'7 ;-- J Zip Code: I, Fax:`77 -Web'S?37
E-Mail: 12 A Phone No.1 -
Fin M fee rimple Tale Molder an next page(if different E-Mail-
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from the Owner Il ed abowe
) State or County License: �
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If value of mnsteuWm is$2500 or mare,a RECUMo Notice of commencement is na kid.
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02/06/2018 03:29 7724663737 BOYLE
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SUPPLEMENTAL,CONSTRUCTION LIEN LAW INFORMATION:
6WI-NE ENQINEm Not Applicable MORTGAGE COMPANY.- I,4 Not Applicable
Name: Name: I !
Addire S$• Address: I 1
State:__M____ City: 1; I i'! 11 o e:
Zip: Phone: Zip: Phone: I'; li
FEE SIMPLE TITLE HOLDER: �Not Applicable BONDING COMPANY: j _..;'—Not Applicable
Name: Name:
Address: Addrm: I:'
City. City: I
Zip; Phone: Zip: Phone: I
I CeTdiy tW no woek or installation has commenced prior to the issuarwe of a permit
St. eie Couhti�makes no rep an that Is granting a prfntik ii u prize the 'holde to build the subject std t r
vrhl Is in con with anx apPi�i�Flome clwners Ass�ciatcon rtaws or a covenants tat ireay strict or r�hib such
structure.Plow consult vR f�your Home Owners Assodation and review your deed any'restrfctians which may apply.
In consideration of the granting of this requested permit;,I do hereby agree that I will.in a8 iirrspects�perfomn the work
in accordance um the approved plans,the Florida Building Codes and St.Lucie County Amendments:'
The fallowing butWkeg permit applkxftm are exempt from undergoing a full ooncurrency review:room additions,
accessm structures,swirnening pools,fences.wails,signs,screen rooms and accessory uses to another non residential use
WARNING TO OWNER:Yaw failure to Renard a Notice of Commencement may iesult hi your peytnE twke for
Iltnpcnvements to your property.A Notice of Commencement must be recorded and posted on the#obsit e
before the fiat inspection.If you intend to obtain flnanting,consult with lender or an attorney before
COMmencinit work or recording our Notice of Commencem9n I {
Signature of 0" fAgent! Signature of Cont dcwAlCense Hol r
STATE OF FL!C W SCATS OF FLORIDA
COUNTY OF AMU COUNTY OF -
The Uric ar3rnowiedged before me The instrument was ac�owledged before me
this dry of 20 J*by , this day of I ! zu- aC by
(Name of person acknowt g) (Name of person aclmnowi
'06)I,
(signature of Nota771t
, iof Florida)
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f�1 State of 1loriria)
4,
Personally Known Produced identitkation personally
Type of W L
Type of I **TV PL
-Ilti«1f of Pk�tMpt
CffNiBTiNE J.C Gommissio rllon 0 Qt 3>P�
Comm - comm''txpire51, tt,p040
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SFA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW! � 'REVIEW RFVIFW
DATE �
COMPLETE
INITIALS