HomeMy WebLinkAboutBuilding Permit Application 05/28/2020 23:44 7724663737 BOYLE PAGE 01
5178
ALL APPLICARIf INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date' S tat ZA Permit Numberf�• D V be
Building Permit Application
Planning and Development Services J
Building and Code Regulation Division
2300 VI ginlo Avenue,Fort Pierce rL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox,click arrow at the end of line
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Address: Jr NO We. M45•
Legal Description:
Property Tax ID#: 1 _3 - Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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ke,: *i&t1 n I+ 5.69A :a"' xdc yU*t-..
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�'� >ar� :,.:.,A;?.:,:.�'�'�G:'7"�8�£;.'tin"•'.vC.
al WQTK 110 n[jrrorrned un a er this perm -check all M appy:
HVAC Gas Tank as Piping Shutters Windows/Doors
Electric 11 Plumbing ❑Sprinklers Generator U Roof
Total Sq,Ft of Construction: '1 r-N1 S .Ft.of First Floor.
Cost of Construction:$ `flD-0.0 0 Utilities. Sewer Septic Building Height:
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Name950. Name: Ffthiiki
Address: a RQU S 7*1( &��-_ Company: ISR c
City:k( f State: Address: lQ i
Zip Code: IRW Fax:
Phone No. 610 - 30 9!U 3 Zip Code: 3�5� Fax:-77,2-- 3'J3h
E-Mail• Phone -
Rif In fee simple Title Holder on next page(if dtfferent E-Mail:��lQoCo pi_
from the Owner listed above) State or Co my Licen e:_ChC13IV 3
If value of construction Is$2500 or mare,a RECORDED Notice of commencement is requked.
05/28/2020 23:44 7724663737 BOYLE PAGE 02
SUPPLEMEWAL CON.MUCTION UEN LAW!FORMA'T'ION:
flESI6N ITS: —Not Apjlicab1e NIORTME C ANY: —Tat Applicable
Name: Name:
Address: Address:
City: State_ City: smte:
ap: Phone Zip: - Phatre-
FEE SIMPLE TITLE 1401.064 _,j--,Not Applicable BONDING COMPAW; Not Apptic able
Name: Name..
Address: Address!
City.
Zip: PhorW. xcp:_ -- - Phone_
OWNER/CONTRACMIt AFRDVff Appl oWan is hereby made to obtain a perm tto do the work and tnstaliation as indicaW&
I certify that no work or instaiiatlon has a0mntenced prier to the lWuua�nm of a permit_
S�Duci �rrrai�s na tesentatlon ti>ax IS granting a Aetmitcuies. the holder to btaitd the sablect strkicture
sStrhuic 5:?lease con�dk�yo�ii�o gw,�Asso��arnt(ewiew}tauc derc�d���t�ct�"ts+s�apply�t�t sut�
in candderation vF the gimneng of this requested permit,i do hereby agree that i will,in all respeCK perform tate work
In aawfance with the appmved rbos,the Ronda RuMrq Godes and St..Lucie County Amenchno ts.
The faHuwir}g building permit appitcatlons ate exempt fire m undergoing a full concercrency rav€w,room additiom
accessory sumwre%,swftnrftrg per.latices,"s,signs,screen rooms and accessory ums to another ttotkweddenliial use
WARNING TO OWNER:Yaw f>aillure to Itemrd a NWm of Cmamesrwtilm may rawft in Yost peft bdm for
improvements to your property.A Nt)tioe of COMMenc ement muse be recorded and pasWd on the jobsite
before the first inspection.If you intend to obtain#Inane tR,consent with lender or an attorney belbre
tx mmendnit work or recordinx Your Notice of Cornmencemem
Siginature ofmikierlLessae/Contracto Agent r er mature of ainaractorAlmaw Homer
STATE of FLORIDASTATE OF, �,t -��, COUNTY V �A -��C�
COUNTif OIF
The fuping katr ument was acknowledged before me 'Che ing instru ent was admovAedged before me
this 114 day Of _� zo�4 by dtis��v of� �.,. ���by
JF S� IZ-, 00vI
Name of ement Name of verAvuemAg staitAftent
Personally Keo" )Z OR OProdtm d lddrid ijcm Personally Known V OR Pnxkx ad Identifica43on _
Tvoe of ldentuicabon Type of lden4fica3tion
Produced Produced
Aa& &6141 w-
{SwatxkreF lit_Staleof s[sdd_a j= (SignaturecO==State of Fiatititt)
++++++ CHRISTINE J.CQNWI;i L
CdntmtSsl lic-5fa orida Comm two o .+""� CHRISTQq§J.
Commission#GG 017839 otary uido
My Comm.Expires Aug 21,2020 zCommle020., aFs�.` SSn.1141!ii, Bon ud tbrou
REVIEW Q D l 3 VLSQR PLANS it, ROVE
COUNTER RLMEW RlrVti_W REHIEW REVIEW PznEw REVIEW
DATE
RECEn71ED
DATE
COMPLETED
Rev.ON17