HomeMy WebLinkAboutBuilding Permit Application 04/24/2018 03:20 7724663737 BCYLE PAGE 01
ALL APPUCABILLE 7iNMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED y
Date: T Permit Number:
•
Building Permit Application
Planning and Dcvclopment Services
Building and Code Regulation DivWon
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR:^To Select from dropbox, click arrow at the and of tine
PROPOSEDIM:PF40VEMENT LOCATION:
Address: I-70ti- A,,& eae. oqs
Legal Description: OOik Park , U,41� ,,
Property Tax ID g: -- - - - Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back:__ Right Side: Left Sale:
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CONS ROMON'.INFORM;rA N:
nalwor tobfirtormed—t rider t rm s pet-c e a apply
9tVAC
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(,as Tank 06as Piping _Shutters Q Windows/Doors
11 Electric Q Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: SFt.of First Floor:
Cost of Construction: $y Utilities1]Sewer D Septic Building Height:
OWNER/L lEME:
Name I/ Name:
Addres : lio Ic PONI Company:
City. 1 Cf. State= Address:` JpI LT J
Zip Code: �� Fax: .r�}' City: r( t i j State: F11
Phone No_ �r] -� rj��. �q Zip Code: „N q`S I Fax:11)-"Ritf-n 37
E-mail; Phone No. L4(
FI11 In fee simple Title"der on next page(tf different E-mail:
from the Owner listed above) State or Co my License:
if value of tonstructlon Is 32500 or more,a RECORDED Notice of Commencement is required.
04/24/2018 03:20 7724663737 BOYLE PAGE 02
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNS ENGINEER: T Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address;
City: - State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOUXR: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name-, _
Address: _ Address:
City: City:
Zip. Phone: Zip: Phone-
I certify that no work or installation has commenced prior to the issuance of a permit.
St.ge Count makes no rep Upon that is granting a permit wiH authorize the permit holder to build the sub#ect cture
which is in con ict with any ap le Home Owners Assoc ation rules,bylaws or and covenants that may restrict orprohibit such
structure.Please consult with 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 will,in all respells,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The following 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:Your failure to Record a Notice of Cornntencentent Wray result In Your paying twice for
improvements to your property_A Notice of Commencement must he 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 our Notice of Commencement.
Signature of /Agent/ a Signature of Contractor/License Holder
STATE OF FLORIDA � , CSTATE OF OUNTY OF FLORIDA
COUNTY OF
The forgoing ins mint was acknowledged before me The forgoing instrulvent. was acknowledged before me
this PM day of \ 20)e this_day of (� 20-W b
(Name of person acknowledging) (Name of person admowdedging
(Signature of Notary Pu Late of Florida) ISlgnature of Notary P c-State of Florida)
Persona y RRtak aertMri�h on Personalty o �iuced i tlo
Type of P44w4cpsw •state of FIo►l0a 'type of id
r a � GGU1It
Commleeloa 0 tic 017 = Comm"' 2020
Comm- omm Ex fru Auq( 20 Commission cm n i.vuee
tipndrrC tArwo wool N014pi Mea. � � �pMetl .ah NMwrrel Not A/li�
Revised 07/15/2014
REVIEWS FRONT 70NING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS