HomeMy WebLinkAboutBuilding Permit Application 06/10/2018 20:17 7724663737 BOYLE PAGE 01
ALL APPLICABL Iffo MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTEn
Date: Permit Number: I '0 2,51
.J•_ .RECEIVED
Building Permit Application JUN 1 1 2018
Planning and Development Services
Building and Code Regidotion blvision ST, Lucie CountyPermitting
2300 Virginia Avenue,Fort Pleree FL 34982 --
Phone:(772)462-1553 Fax:(•772)462-1578 Commercial_T Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
16,01W N. -AMATI1014
.;
Address: t Q Ir e,
Legal Description
Property Tax ID#• Lot No:
VC
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side:.__...___... Left Side:
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Addita vuor o forme under is permi•-•c•.eC a appy.'
HVAC Gas Tank ❑Gas Piping _Shutters 1 1 Windows/Doors
Electric 1:3 Plumbing Sprinklers ❑Generator 11 Roof
Total Sq.Ft of Construction: S .Ft.of First Floor:
Cost of Construction:$ 7��. �� UtHitles: Sewer Septic Building Height:
Name Name: I
Address. Company- t01
City:_ Q rt NState_ - Address: -
Zip Code: Fax: City state: .�
Phone No. _-_ Zip Code: f ? Fax:
E-Mail: Phone No. thl
-
Fill In fee simple Title Holder on next page(If differmt E-Mail: m
from the Owner listed above) State or Co my License:
ff velue of construction is$2500 or more,a RECORDED Notice of(Commencement Is roquirad.
06/10/2018 20:17 7724663737 BOYLE PAGE 02
;UPPLEMENTAL CONSTRUCTION LiEN iAWI INFORMATION:
)E51GNER/ENGINEER: _Not Applicable MORTGAGE COMPANY; Not Applicable
dame: Name:
Address: Address-
3ty: .._State:— City: -
1p: Phone: Zip: Phone:
:EE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: —Not Applicable
lame: Nalme-
►ddress: Address:3tv: city:
.
_..
'1p-
Phone: Zip: ... Phone:
certify that no work or installation has commenced prior to the iswance of a permit
t. a county makes no represer�t�tion that is granting a ppermit viii ab orize thesermit holder to build the subject s#ructure
rhi sin con id with any appiia a Home fawners Asg a ation rues, ws or an covenants at may restrict or pro it such
tructure.Please consult w tl your Home Owners Association and review your deed for any restrictions whirh may apply.
i consideration of the granting of this requested permit,I do hereby agree that I wtll,In all respects,perform the work
r accordance with the approved plans,the Florida Building Codes and St.Lucia County Amendments.
he following building permit applications are exempt from undergoing a full concurrency review:mom additions,
ccessory structures,swimming pools,fences,walls,signs,screen rooms and attemry uses to another non-realdential use
NARNING TO OWNER:Your failure to Record a Notice of Commencement may result:in your paying twloe for
mpprovements to your property.A Notice of Commencement must be recorded and posted on the jobsite
Iefore the first inspection.if you intend to obtain finaneft consult with lender or an attorney before
ornmeming work or recordk(ig yqur Notice of Commencement.
signature of Oren t/Agent/L e SigneRure of Contractor cense Holder
TATE OF FLORIDAC (�, STATE OF FLOIt10A ��
BOUNTY OF �J l . 1 '1 L COUNTY OF
The fo ing instrument was acknowledged before me The for ng inswrumrnt was acknowledged before me
this day of y�l,l L , 20$try this�day of
W&101 L k6of �,'
Name of parson ackrlrmisdgl R] JName of person acknowledging)
LJ
(51gnature of Notary - FI ti (Signature of Notary Pu to of Florlda)
C I TIN7; CONWEI.L
personally Known ° �� Personally Known u
Cype of Identificatio p, Type of kirytttfkat
My Colum,Ex ires Aug 21,41A1 l• COmmiarlon N eA 017119
;ommission No. ,;R g p'i�tUonil y A7IlI1. Commission No. 3 y Comm.{"Art 21,2020
9ondid Ihrougb!pitiless Not p Assn.
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
BATE
COMPi,EiE
INITIALS