HomeMy WebLinkAboutBuilding Permit Application 04/05/2018 00:42 7724663737 BOYLE PAGE 01
ALL APPLICAR INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEMID L�
Date: r Permit Number:
LAPR
ECEIVED
Building Permit Application 0 5 2018
Planning and Aevelbprnent Services
Building and Code Regulation Division Count , Permitting
23W Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)46.2-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the and of tine
RS ! 'ltNT
Address: Vie e_ cj
Legal Description:-121
115/j
Property Tax ID#: - Lot No.
Site Plan Name: Block No,
Project Name:
Setbacks Front Back: Right Side: Left Side:
( lL t
WkQ ( [4* :ins .Ll n&,/ 1+10n� 14 sten U4ire. e px.IcX2 U1l
W i-Yh 10 K W h)
i work 0 tisi2erformed unclarthIS permit-check all thA apply:
12!HVAC 11 Gas Tankas Piping _Shutters a Windows/Doors
11 Electric Q Plumbing H6Sprinklers 1..�I Generator 0 Roof
Total Sq.Ft of Construction:AUO.
.Ft.of First Floor:
Cost of Construction:$ AUO•d 0 Utilities O Sewer 0 Septic Building Height:
Name Name:
Address: 15 DANZar_ ompany: 1
City: _State:f'L Address: 1, P.�
Zip Code: .3 �Jl � Fax: fo A City: �" ESL State:-9--
Phone
Phone No.3� '�$L� -MIC IC( Zip Code: Fax: I7��-, 73�
E-Mail: b!JA Phone No.'77,1- I-
Fill in fee simple Title Holder on next page(if different E-Mall. irono
from the Owner listed abme) State or CFuntyLicensk eke i$I 3(
if value of constnxtion is$2SA0 or more,a RECORDED Notite of cammenewunt it required.
04/05/2018 00: 42 7724663737 BOYLE PAGE 02
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION_
DESIGNER ENGINEER: Not Applicable (MORTGAGE COMPANY_ Not Applicable
Name: Name:
Address: Address:
City: Sbte: City: State:
Zip: Phone: _ _ Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name: _
Address: Address:
City: City. �.
Zip: Phone: Zip: p}1qrte.
I certify that no work or Installation has commenced prior to the K-wane of a permit_
5 .Luuae County makes no repres"tion that Is granting a hermit u fl authorize the permit holder to build the subject acture
ith is in conRict with orgy applicable Home Uwners Assoclatiati rules,byFaws or and c�nants that may restrict or prohibit such
structure.Please consult
wft1�your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby agree that I wtft,in ag respects,perform the work
In accordance with the approved plans,the riorlda Ruildfng Codes and St.Lucie County Amendments.
The following building permit appiications are exempt from undergoing a full concurrency review.room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER;Your failure to Record a Notice of Cormnencernent may result In your paying twice for
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. if you Intend to obtain financing,consult with lender or an attorney hefore
commencing work or Fetor__.irvur Notice of Commencement.
Signature of 0*rnecfAgent Signature of ContractWUCense Holder T
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF I Q� COUNTY Of
The f nine i meet was acknowledged before me The forgoing Instrument was acknowledged before me
this day of zo$byC' this day of 20__Ig b
(Name of person acknowied g) (Name of person acknowledge )
(51ature of Notary P Ik-51LZLoffkmidtj (Signature of Notary - e
Pe tioWELL
n y a GMIII TINE J. ONQ 0FIsiW tion _
Typ Type n �)
Com is g) Comm Expir#t A p0�0 C� My Com � � xr2e20
, _.. pygpl►MNpnai NoiY
Rcviscd 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW RMEW REVIEW REVIEW REVIEW
DATE��
COMPLETE
INITIALS