HomeMy WebLinkAboutBuilding Permit Application 05/07/2015 12:05 7724663737 BOYLEAC PAGE 02
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO OF ACCEPTED 6 Oq.
Date: permit Number: 1505
`I Building Permit Application
Planning and tevelopment Servkes
Building and Code Regulation Dlvlslon
2300 Virginia Avenue,Fort Pkrce F!34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential ,
PERMIT APPLICATION FOR: To Select from dropbox,click arrow at the and of line
PROPOSED IMPROVEMENT LOCATION;
Address: (P 2•0 1 I
Legal Description:
Property Tax lD t1: 3A10- 563A60 01 0 000-$ Lot No.is r-
Site Plan Name: Block No.
Project Name:
Setbacks Front ._-.- Back: Right Side: Left Side:.
DETAILED DESCRIPTION OF WORK:
0�494&[ a 3.5 ton 15 Seed" ReOL+ W s rm� hee ryi.
CODS CTION-INFORMAtION:
worK to Orme under sperm -c eCK all appy:
HVAC Gas Tank as Piping Shutters O Windows/Doors
ClEiectric Plumbing Sprinklers �taenerator 13 Roof
Total Sq.Ft of Construction; _ S .R.of First Floor:
Cost of Construction:$ o Q• Utilities Sewer Q Septic Building Height:
CONTRACTOR:
OWNER/LESSEE;
M 1
Name:
Name , ' r
Company-.
Addres : an
.
State.VV Address:
City: ._State:—L-
Zip
2ipCode• Fax: � CitY:kkff-4 -
Phone No. Zip Code: Fax:
E-Mail- PPhone No.
Fill In fee simple Title Holder an next page(If di#erent E-Mall:
from the owner listed above) State or Ca my License: r
K value of constraco on is SZ5W or mora,a pECORMO Notice of commencement is requlmd. NJ,
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85/07/2015 l2:05 7724663737 BOYLEAO PAGE 03
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41 1-C7RICUT91�IT
,SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNERANGINEER". Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name
Address; Address.
City; State: City.'
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name.,
Address; Address:
City: Cltv:
Zip: Phone: Zip:—Phone;
I certify that no work or installation has commenced prior to the issuance of a permit
:,,L ,de,Cour Mal no represe,%trtion that is granting a fm mit Lill apporize the permit holder to build the subject 10
J,S peon
aj
arl
s"cture.Please consult your tiome Owners Assoclafflon and review your deed for any restrIctiot Ally
in consideration of the wanting of this requested permit I do hereby agree that I will,in all rewcts,perform the work
In accordance with the approved plans,the Florida Building Codes and St.Lucia County Amendments.
The following building permit applications are exempt ftm undergoing a full concurrency review;room additlans,
accessary structures,swimming pools,fences,wallsOgns,screen moms and accessory uses to another non-Tesidential use
WARNING TO OWNER.,Vour ftillure to Rmmrd a Notica of Cwnmencament may rault in your Wong twice for
'm erits you�r prop rtv.A Notice of Commencement must be recorded and posted on the Jobske
beforroevtehme first'lospection.I you Intend to obtain financing,consult with lender or an attorney before
commencing work or recor nil your Notice of Commencement. ---- 11%
X edr�. P,/Z-J� — d, L c
Signature of owner/Agent/LeVdF XWn=Xr LlCenseftlder
di
XR� Oak
STATE OF F STATE OF FLORIDA 0. 1
COUNTY 4M Ide-, COUNTYOF IA46L
The forgoing instirument was acknowledged before me The fo Ding Instrurpent was acknowledged Ware me
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(Signature of Note�PPUbll a of Florida) ISIgnature of Nomry PuP6 State of Florida
Personally Knovwmn OR Produced Identification Personally Known OR Produced Identification
T081APne Type of Identification Produced Cook 101-tit
Type af identification Produced 22- - AL
7. 7MFr*rMuy IC
L— 0POR116 AMIMM IN,
Revised 07/15101
REVIEWS FRONT ZONING SUPERVISOR PLAN$ vEGETA-noN SEA TuRnE MANGROvE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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