HomeMy WebLinkAboutBuilding Permit Application . Feb. 4. 2016 9:50AM Litchfield Co. — Murrells Inlet No, 1256 P. 5
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:A-t--W1', Permit Number:
:_,; ,23, -..s;:.%i,—_ RECEIVED
Laud,
6PlanBu-ild-ing-Permit Application EB - 42016-
Planning
ning and Development Services
Building and Code Regulation Division
1300 Virginia Avenue, Fort Pierce FL 34981
Phone: (772)462-1553 Fax:(772)462-1578 Commercial Residential _L
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
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Address:
Legal Description: Pyq (- LO-T l tr/Y1fl�t�
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Property Tax ID 4: ' I D – a61aLot No.
Site Plan Name_ U a Rctrr►-s Block'No. c9 I —
Project Name: lbu -F-• 014H_ 1(2x
Setbacks Front Back: Right Side: Left Side:
DETAILED"DESCRIPTION-OF-.WORK;-'. .
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1,-CONSTRLICTION:INFOR _`TION.MA ,
Additional work to e e orme under this permit–check a appy:
HVAC []Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
LlElectric 0 Plumbing Sprinklers ❑Generator Roof
Total Sq. Ft of Construction: V�J_N 5 . Ft-of First Floor:
Cost of Construction:
Utilities: Sewer U Septic Building Height:
0.WI4ER/��S5E„ — '
rName Phu !k Oa-r V -k& Name: Lic
Address:,. (,u S+ , Company: CM1 Mr w'ii
City:-4 (,:ZIA , LLX1J e 5tate:fL Address: 'LI(6I 7SO iL �-wi FW C, 4.613
Zip Code:� � Fax: City: In k e Stater-'i-
Phone No. Zip Code: 3AL�It-1 Fax:S S$-3�-TMT"t
.E-Mail: - Phone No. gal -C(15--111fin
Fill in fee simple Title Holder on next page(if different E-Mail: i)'r ry-1, 5 cool 11 rL M .CayM
from the Owner listed above) State or County License:
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Feb. 4. 2016 9:50AM Litchfield Co. — Murrel,ls Inlet No. 1256 P. 6
DESIGN ER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name;
Address: Address:
City: State: City: State:
_ ._Zip.: Pbnnp: _Zip.; Phone,
FEE SIMPLE TITLE HOLDER: _✓*i lot Applicable BONDING COMPANY: _Not Applicable
Name: Name: _
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St.Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Ducie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property. A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing,consult with lender or an attorney before
commencing ork or recording our Notice of Commencement.
s
_Signature of Ow er/Lessee/Agent nature of C tracto /License Holder
STATE of FLORIDA STATE OF FLORIDA
COUNTY OF COUNTY OFA nit.
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 44 day of 20 Eby this_�/_day of a 20 /(, by
(Nameper-son acknowledging) (Name'9f person acknowledging)
( ignature of Notary Public-State of Florida) ( I ature of Notary Public-State of Florida)
Personally Known OR Prpriurpri Personally Known L-'� OR Produced Identification
Type of Identification Pri idv(A"',' ANGELA CFCll IG MARTINEZ Type of Identification Produ
a''.�r ANGELA CECILIA MARTINEZ
j'd MY CrO�pMMISSION-eFF039952
Commission No. t E�XN1��S July 25,2017 Commission No. 's rat($�l).tISSION#FFo39952
°4r"• J \°�pe��o '` EXPIRESJuly25.2017
U07 399.0163 FlorldaNOWNServl04.o0m
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS