HomeMy WebLinkAboutBuilding Permit Application 04/23/2018 02:05 7724003737 BOYLE PAGE 01
ALL APPUCA LE INFO MUST BE COMPLUED FOR APPUCATION TO BE ACCEPTED t �
Date: 3 Permit Number. C•�\ Q
RECEIVE
Building Permit Application
Planning and Development Services - APR 24 2 18
Building and Cade ReguMbn Division
Permitting DePa eat
23W Virginia Avenue,fort Pierce FL 34982 St. Lucie COL Ity
Phone:(772)462-1553 Fax:(T72)462-1578 Commercial Residential
IV/
PERMIT APPLICATION FOR: To Select from dropbM click arrow at the end of line
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Address; ore'15 t* Igiz A Liq S
Legal Description:
Property Tax 10 M Lot No,
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: , Left Side:
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:' � yam,?��('l .�'., ,,,., ;•:;;.',:':;:;'• �%;s_• ..r--.....t.'s�'i:='-•'��r��.
ono work o e orme un erffas
erm — e 0 appy:
❑HVAC be
Piping _Shutters aWindows/Doors
Electric 0Plumbing Sprinklers El Generator hoof
Total Sq.Ft of Construction: S ,Ft.of First Floor:
Cost of Construction:$ 4406- 00 UtilRies:12Sewer Septic Building Height: _-
At
Nam 1 A. Name:
Address: WA Company:
ty:Ci ,+(��•. .--�(;�.Q�----_-- State:� Address: �(
r - -
Zip Code: Fax: City; State;/
Phone No. 112=-91%2502 Zip Code:
E-Mail: Phone No.
Fill In fee simple Title Halder an next page(It dtl1went E-Mail:
from the Owner listed above) State or County License.
M value of construction Is$2500 or more.a RECORDED Notice of Commencement Is required.
04/23/2018 02:05 7724663737 BOYLE PAGE 02
SUPPLEMENTAL CONSTRUCTION UEN LAW INFORMATION:
MIGNER ENGINEER: ^,,,,,Not Applicable MORTGAGE COMPANY: _Not Applicable
Name-, Name:
Address- Address:
CItT_ State• City: State:
Zip:_ _Phone: ., up: Phone:
FEE SIMM TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: - Phone: „„• . . Zip: Phone-
1 certify that
nntoo work or installation has commenced prior to the Issuance of a permit.
T1s m�coiriiim with any a e Homeat Is gmnt a omn�illll authorize the holder to build the subj�s r cture
structure.Please consult ny ap bHom Home
ers and ides,bylaws or aen nacos tW m restrict or rohibit such
your deed any restrictions which may apply.
In consideration of the granting ofthis requested permit,l do hereby agree that 1 will,in all respects,perform the work
In accordance with the approved plans,the Florida Building Codes and St.Lude County Amendments.
The following building permit applWlons are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Yow faOM to Record a Notice of Commemenu rtt malt'result In your p>ayme twice for
Improvements to your property.A Notice of Commencement trust be recorded and posted on the fobsite
before the first inspection.If you Intend to obtain financing,consult with lender or an attorney before
commencine work or recordine vour Notice of Commencement.
Signature of /Agent) ee Signature of ContrKWAX06se Holder
STATE OF FLORIDA . r r,n;� STATE OF FLORIDA I ,,,, ,
UJ
COUNTY OF u► ''"'�` COUNW OF L
a- & -- --- -
The forgoing instrument was acknowledged before me The forgoing in ment was admowledged before me
this day of ( J 20 by� this, day of W4 __,20$by
( �
(Name of persolt adtnowledging) (Name of person owledgt
f .�lr.•l�c/
(signature of Notary ic-St Florida) (Signature of Notary llu- tale of Florida)
Personally pdMierfdedMMlt6�a Persona on-
Type of Ida a at 1`101142 Type of tare of ffot>d
Commillim 4Q 017839 _. Commission r GG 01, 1
Camrri�ssioCOMM.Explles(W,2020 Comm plies Aug p
0ondsd througo Nilion2l N011r AWr• p#ArOuph Nstion�l Notary Aattll,
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW RPAEW
DATE
COMPLETE
INITIALS