HomeMy WebLinkAboutBuilding Permit Application 06/01/2018 03:27 7724663737 BOYLE PAGE 01
ALL APPUCA L INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 1 oo
ti
Llon
ED
Building Permit ApplicaPlanning and Developmentselvices 018
Building and Code Regulation Division 2300 Virginia Avenue,Fort Pierce FL 34982 Permit n9
Phone:(772)462-1SS3 Fax:(772)462-1579 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
RROPOSM 1�'!`�PROVEI ENT, LOCATION: ;
Address: OCZq5
Legal Description:
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front_ Back: Right Side: Left Side:
DETAJ r:DW,R FtION OF WORK;
.y>
l.J r�0� U i15 3.5 4VI/ L 4- 5ee1~ N e. USI
Uto�rl� P7R��o�kZk
C C�'hQ i # ( Rl!�FATIDN: ;: .
i i a war o orme under is permit—c ec a app
VAC
H 911 Gas Tank �GaS Piping Shutters Q Windows/Doors
Electric El Plumbing Sprinklers 1:1Generator Roof
Total Sq.Ft of Construction(: Ft.of First Floor:
Cost of Construction:$ "ry UtilitiesSewer IJSeptic Building Height:
Name Name:
Address: Company:
5
City: _ i Address:
State: •
Zip Code: Fax: City; State: " i
Phone No. Zip Code: �11 Fax:M 4kJ&
E-Mail: Phone No. -A
Fitt in fee airn'pt on next page(if diffOrent E-Mall:
from the Owner listed above) State or County License: {
It value of construction is$2500 or more,a RECORDED Notice of commencement Is required.
06/01/2018 03:27 7724663737 BOYLE PAGE 02
UPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
IE5IGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
lame: Name:
address: Address:
7ty: State: City: State:
;ip: Phone: Zip: Phone:
EE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: _Not Applicable
lame: Name_
►ddress: Address:
:ity: City:
Jp: Phone: Zip: Phone:
certify that no work or installation has commenced prior to the issuance of a permit.
t.Lucie County makes no representation that is granting a permit i!II auth ri:e the permit holder to build the subject structure
rhich is in Wnffict with any applicable Home Owners Association rules,byh►ws or and covenants at may restrict or prohibit such
tructure.Please consult with your Home Owners Association and review your deed for any restrictions Which may apply.
i consideration of the granting of this requested permit,l do hereby agree that I will,in all respects,perform the work
i accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
he following building permit applications are exempt from undergoing a full concurrency review room additions,
ccessory structures,swimming pools,fences,wails,signs,screen rooms and accessory uses to another non-residential use
NARNiNG TO OWNER:Your failure to Record a Notice of Commencement may result In your paying twice for
mpprovements to your property.A Notice of Commencement must be recorded and posted on the jobsite
wfore the first inspection. If you Intend to obtain financing,consult with lender or an attorney before
zmmencing work or recordin your Notice of Commencement.
6pee Ix
signature of owner/Agent/Lessee Signature of Contractor/Ucense Holder
iTATE OF FLORIDA ��LL t ��` STATE OF FLORIDA
^AUNTY OF C71, 12� COUNTY OF
The forgoing meet was acknowledged before me Tha ng instru�r Hent was acknowledged before me
this�day of JWJL . Z+J ]'1' this day of-I r I[1 .20�by
_IT �Iap'l V. BOA
;Name of person admowledgi `9 (Name of person acknnwfedgl )
(Signature of Notary Ic State of Florida) (Signature of Notary State of Florida)
..■
Personally Known �{� personally Kn ptgl,Jldentlfl 0,on
type of ldentiRcati P CNAiflT1NE J.COIYwE type of Id up t r ur u a
Koury Public•aw W florwo Z
aluian It " " `'
Commission No. comff"o cc 017130 Commission m.Erptre {Seal) '020
Comm.EMPIn1 Auo 21,2028 1aA0MtArou9n Naar ae1n.
hw,
fNNiNd NMioeai Noir so
Revised.07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS