HomeMy WebLinkAboutBuilding Permit Application 06/17/2018 20:16 7724663737 BOYLE PAGE 01
ALL APPLICAW INFO MUST BE COMKI ED FOR APPUCATION TO BE A kC(XMD ® r',I
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Date: Permit Number' NO .
f. 9i
Building Permit Application
Planning and Development Servkes
Building and code Regulation Division
23W Virginia Avenue,Fort Pkrce FL.34982
Phone:(772)462-1553 Fax:(772)452-1578 Commercial Residential
PERMIT"APPLICATION FOR: To SeW from dropbox, click jirrow at the end of line
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Address: //}}�� ff l 5
Legal Description: 1 lu1�11 C
Property Tax ID#: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: _ ft Side:
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a wo' a : orme un er perm — e a app
HVAC Gas Tank as ' 'n Shu 'rs
!� 6 �Wirldows/Doors
OElectric LTJ Plumbing Sprinklers Gen rator Roof
'total Sq.Ft of Construction:.____ .Ft of 111Floor-
Cost of Construction:$ �[�.�� Utilities: Sewe septic Building Height:
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Name Name:
Address; L Company: •� ,
city: State: Addr n
Zip Code- Fax City: state.. R_,
Phone No.-7-7,2 ..(�(�Y Zip Code: Fax: �-' rL
E-Mall: Phone o. A141
Fill in fee simple Title aider on next pie t if different E-Mall:
from the Owner listed above) State or Co my Ucense:
If value of mm"MM1s SMW er"lore.a REMOnED Nation of Commanamelt IS"aqulred.
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06/17/2018 20:16 7724663737 BOYLE PAGE 02
'SUPPLEMENTALCONSTRUMON UEN LAW INFORM,Ano�f:
DESIGN EEtt : Not Applicable .
Mame- Name: AGiE COMPANY: Not Applicable
Address: Name:
City,
State• W. ��„ State:
zip: �,.__Phone: Zip: Phone;
i
FEE SIMPLE TIRE HOLDER: Not Applicable BONDING COMPANY: —Not Applicable
Name: Nam.
Address- Addresm
aty: City: I
Zip: Phone: zip:I phone:
i
I certify that no work or Indanatfon has amlimenced prior to the issuance of a pennit
St.�tie trtr�tyy makes no that is t�aperm it Will t�idrize til�e Feoldep build the subject re
whlrh is inconNct with anY- a Hume Owner AS�atiation odes Ora covenants th
structum Please coniult raiglneOwners Assodatkm and nertew your d�restrkttons wh�a�auch
In tonside mtlun of the grant ft of this requested permit,l do hereby agree that I will,in all respects,perfprm the work
in accordance with the approved plan,the FkMal lit ilding Codes and St.Lucie CkwntV Amendments.
The fAlkowirrg builriins perrnit appikatlans are exempt froth undergoing a full ror�urrexy r4wiew..ruum additiow,
aot=SWV structure%swlmtr IM pools,fences,wall$,signs,screen rooms and accessary uses to another non-residential use
WARNING TO O"ER:Yaw hilum to ttecord a Notice ofCanrnanctnr�ME"result In yMlr Paytrrg Luke for
Improvemterits to your ppropertV.A Notice of Commencerrlent must be nmzwded and posted an the Jobsite
before the first inspect If you Intend to obtain fl<nandrtg,consult with lender'or an attorney before
commencing work or r+ecordin r Notice of Commencement.
Signature of Owner/Agent/Lessee Signature of C /License Holder
STATE OF ROWDA �- �;� STATE
�O�fi/� IDA �
COUN i/OF COUPMOF
OF
The was acknowledged me The to was admwa4edged before me
this Cif a0 AFY Ov—, thIS day m l�'hll
WK6 E bo All , $o
(Name of persona edging) (Name of person adcnawl aing) ���._
(Signature of Notary (lo- of Florida) ( Aurc of otary to of Florida)
Persanaf Per9ahaNy Ktrorn OR Produced Identiflcatlon
Type of 1 E I gONShb Type of
Notary PublicStile 01 fbrin "" CHRISTINE J.CONMLL
CvrnmCOMMISS1011
# Op1WN Noury Pubik•Ilme 001110
• My Comm EAplte%46211.2 COrnmlfllon N as 017879
AS". my Comm.Ea Iran Au 21,2020
8o o"tArauph Nil 1w Notiry Agin:
07/15/Zt)14
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATUR LE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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