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HomeMy WebLinkAboutBuilding Permit Application 06/05/2018 23:52 7724663737 BOYLE PAGE Ell ALL APPLI LE NFO MM BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: Q'j� _ Permit Number:o`16 ` y' 0 RECEIVED Plonning and Development Services Building Permit Application JUN 0 6 7010 Building and Code Regulation Division permitting Departm 2300 Virginia Avenue,Fort Plerce FL 34982 St. Lucie Cnunr Phone:(772)462-1553 Fax. (772)462-1578 Commercial Residential PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED IMPRd MENT LocA-'no Address: p� Legal Description: 45 i Property Tax ID#: 1 -ppp_ Lot No. Site Plan Name: Block No. Project Name: Setbacks Front sack: Right Side: Left Side: �►�lr�nSe(' Mode #�(�A�-�CSo�� � �1� �ar�lerlulodd�Ct�A}�u��-D�-g CONUCT-041110,01MOTION i nalwor o Orme under Fiis perm—it---chocka appy: $ HVAC Tj Gas Tank [jCas Piping Shutters F]Windows/boors 11 Electric 1:1 Plumbing Sprinklers Q Generator Roof Total Sq. Ft of Construction: S Ft.of First Floor: Cost of Construction:$ ►i��U. 00 Utilities Sewer 11 Septic Building Height; CONTRACT f"l�� Name Name: Addre��:: Company: �' City: .�. _State: Address: Zip Code,__W51 Fax:�r�T city: state: Phone No._ L• J�l -_52.�I ZipCode: Fax: E-Mail: A Phone No. Fill in fee simple Title Holder on next page(If different E-Mail: '7" ,",/, from the Owner listed above) State orCo my License: (' If value of constructla"Is$2S00 or more,a RECORDED Notice of Commencement is required. 06/05/2018 23:52 7724663737 BOYLE PAGE 02 SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: DESIGNS ENGINEER: —Not Applicable MORTGAGE COMPANY Not Applicable Name: Name: Address: Address: may: State.'- City: State: — ZIP: Phone: Zip: Phone: FEE SIMPLE TITLE HOLDER: —Not Applicable BONDING COMPANY: Not Applicable Name: Name: 4ddress:_ Address: Zity: -- „--- city_ dip: Phone: _ Zip: Phone• I cert9fy that no work or Installation has cnmmencrd prior to the issuance of a permit. :t.Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject s�r�►�ture vhich is In conflict with any applicable Home Owners Association rules,bylaws or antJ covenants that may restrict or pm%%, g such tructure.Please consult with your Home Owners AssoeFatlon and review your deed or any restrictions which may apply. n consideratinn of the granting of this requested permit,I do hereby agree that I will,in all respects, perform the work n accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments. lie following building permit applications are exempt from undergoing a full concurrency review:room additions, iccessory structures,swimming pools,fences,walls,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 mprovements to your property. A Notice of Commencement must be recorded and posted on the jobsite )efore the first Inspection. If you intend to obtain financing,consult with lender or an attorney before :ommencing work or recording our Notice of Commencement. signature of Own /Agent/ ssee Signature of Contractor/1 icense Holder STATE OF FLORIDA a.i ,,nim STATETY FFLORIDA � COUNTY OF VUIY The f rSoinR instrument was acknowledged before me The Ding Instrument was acknowledged before me this F day of 111 au 20 iry�J this day of 7{l,{�Q� 20� by CAr _Q_ ;Name of person acknnwledgi (Name of person acknowledging) (signature of Notary State of Florida) i5ignature of oda) Ie Personally o Personally Kn Q Type of Ides Type of Iden c. • 6' wklhm 71t 0 Aly Camm,Expire A 1,2020 Commission .Exom020 Commission 11=� �MrouO Na ry Assn kpW ftrm n Wssn. Revised 07/15/2014 REVIEWS FRONT 70NING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS