HomeMy WebLinkAboutBuilding Permit Application 10/17/2019 01:41 7724663737 BOYLE PAGE 01
ALL APPUCA9LE INFO M{1ST BE COMPLETED FOR APPLICATION TO BE ACCEPTE
Date: lollb. J
Permit Nu
- D
Building Permit Applicata n OCT 17 2019
Planning and Development Services Permitting De
Building And Code Regulatlan Division `-'p a t m e n t
23W Virginia Avenue,Fon Pieme FL 3a82 St. Lucie C®u tY� FL
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential .
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of One
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Address: 0
till tug.
Legal E)escription; S LT
Property Tax ID#: Lot No.___
Site plan Name: Block No.
Project Name,
Setbacks Front Back:_._._ Right Side: Left Side:
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ditij1hal wor'to orme un er is perms -c era apply:
IZHVAC
pp Y-
HVAC U Gas Tank []Gas Pipini Shutters n Windows/Doors
Electric 13 Plumbing Sprinklers Generator Roof
Total Sq.Ft of Construction: 1 Ft.of First Floor:
Cost of Construction:$ �aD- _ UtilitiesSewer OSeptic Building Height:
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Name Name: MUild
Address: 4Q& ur Company; I
City. .IkP,4rl!2, State: Address:SlD
Zip Code: Fax.-
_- _ city: �0 !� Stater
Phone No.� �Q�_ ,. Zip Code: a"51 Fax:"71.` -4&J-373`�
E-Mail` Phone No. R -AI A-H
tall in fee simple Title Holder on next page(if dMarant E-Maik
from the Owner listed above) state or Co my Licen e: CdkC 181$t
H vaNee of oonstruetion Is$2500 or more,a RECORDED Notice of Commencement is required.
10/17/2019 01'41 7724663737 Bu,LE - ' ._PAGE.. 02
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SUPPLE
Name: _NwApplicable
Address: Address.
Zip: state.
Addrew Address:
Cltj: City:
Zip: Phonj- zip--phone
OwNER/awn—RAcwR Amovin Appamom is hereby naleto obtain a permit to do-the woft and In$taliatliDn as indkated.
I cert1tv that no work or Wallaltion has comMenced prior to the hsuance of a permit.
S%Inde Mmakes no CPM WUM4 dot Is
in i ict with a r 0 dqco I ch
r or
Structure.Please Home Owners Assowtion and mvw-w Vow deed or any
In consitlawlim of the gmft of this mquestW permit.I do hereW agree that I wig,in all mspects�Worm the wotk
in accordance with the approved plans.the Rodda Bullcift Codes and St.Lucie County Amendments,
The*911oveirig buflitilm permit applications are enmpt from undergolm a full concurrencV revirAr room additions,
acummy strucwM swkmvft po*feaces,w*%_qM screen roorns and accessory uses to anallver non-residential use
mprovements to your prope - Notice of Commencement must be recorded and posted on the jobsite
before the first inspection.,if u intend to oWm financing,consult with lendair or an attorney before
STATE OF FLORIDA STAIM OF FLORIDA
no 71, 26JI by
this UO-dayof by this ay
1�fi*of Identification ram of Identification
of bftftftAffWftA:L
Notary Public-State ot Florida
Comm Cammi-rion#GO DOW)
Commission 0 GO 017039
Bonded through National Nolar Aw.
My Comm.Expires Aug 21,2020
PON t row National INOTAI -5".
DATE
DATE
LgIMPLETEE
Rft.8/2117
1441JOAMNOT61 Assn
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