HomeMy WebLinkAboutBuilding Permit Application 06/14/2018 01:42 7724663737 BOYLE PAGE 01
AIL APPUCApg NTMUST 8E COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:. If 9 Permit Number:
Building Permit Application
Planning and DevrhWmEnt Services
Building and CeRegulation DMsion
2300 Vlralniode Avenue,Fort Pierce R 34982
Phone:(772)462-1553, Fax:(772)462-1578 Commercial Residential
PERMIT:APPLICATION FOR: To Select from dropbox, click amm at the and of line
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Address. 51
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I.e$al pescxtption: •
Property Tax ID M � I _05_, 01-15-Doo - Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: L Pft Side:
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�JHVAC Gas Tank Cas Piping _Shu •rs ❑Windows/Doors
OElectric Q Plumbing ❑Sprinklers 06enerator ❑Roof
Total Sq-Ft of Construction: Ft.of Fir Floor:
Cost of Construction:S Utilities Sewe Septic Building Height:
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Name aV I Name:
Address: Company:
City: aw* Pkera, State:VU Address:
Zip Code: 1446 1 Fax: City: TTP r Stater
Phone No:-7-72 0 LaQ Zip Code: 5 L Fax: 1 x3737
E-Mail: Phone No. �kl1k
Fill in fee simple Title Molder on next page{If ditterent E-Mail: 1
from the Ow4er lisW W*ve) State or Cal Ucense:
N value of camtructlan k$2W or nwe,a RECORDED Notice of Carnummmmt Is required.
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06/14/2018 01:42 7724663737 BOYLE PAGE 02
SUPPLEMENTAL CONSTRUCTION UEN LAW ENFoRwn.o
DESIGN E—WNEElk Not Applicable MORTGAt`"E COMPANY: Not Applicable
Name: Name-
Address• Address:
W. State: city. State:
Zip' Phone: ZIP: Phone.-
FEE
hone:FEE SIMPLE TI?1k WI DER: �Not Applicable RtINDING RANY." Not Applicable
Name: Name:
Address: Address:
city:
zip: Phone: ZIP: Phone
I ceruN that no work or installation has commenced prior to the issuance of a rn&
St. cie makers no that Is grantMB a permit wip a onfn
holder to build the subject eture
which is in con -ict with an �ie"orate owners Assns LOw rte,b� venants that mark ar p=such
$UUdture.Please consult with your Home Owners Association and mvf6w youany restrictions whY�appiv.
in emwderadon of the granting of this requested permit,l do hereby agree thInaK rewem,perform the work
in accordam with tate apprdved plans.the Florida Building Codes and St_i ucmendments.
The foliowing bulkong permit application are exempt from undergoing a fully review:room addiaians,
aaxsswy structures.swimming pools,fences,walls,signs,smen rooms and uses to another non-residential use
WARNING TD OMFA:Yaw falinre to Record a Not m of Va. Pavbv twice for
Imppmvemtfl►ts to your property,A Notice of Cornmencernent must recorded and posted on the jobsite
before the first Inspection.if you intend to obtain financinjl,consu with lender or an attorney b+ef6re
commencing work or recording r Notice of Commencement.
Signature of Own Agent/ 5At
STATE OF FUMIDA ATEOF DA
e of Iltrxnse Hoidrtr
COUNTY GI: � C*The��++�l as ackr+crMiedged re me was adatowiedged before sae
thidaany 20-34 by 0
this of ....�,........� ��.��' ($
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{Name of per son adrnowl ng) - dameif '
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ignaiure of Notary • of tgorida) (Signature of ataxy fie of Florida}
Personally Known Oft Ptrad=04!der tI&8%n Personate a Prodgr.>8d Itlentllkatlon
1Vpe of id type ,.
tiiMIfTINE J.C!NMvjLAsw
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f1oftlfteph NANO Novy Asps,
LEREVIMS FRONT ZONING SUPERVISOR PLANS GETATii�N SF.ATURTLE MANGROVE
COUNM REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW