HomeMy WebLinkAboutBuilding Permit Application 03/07/2016 11:23 7724663737 BOYLEAC PAGE 01
Au APPLICABLE INFO MIST BE COMPLETED FOR APPLICATION To BE ALCM ED
Date: Permit Number:
RECEIVE®
Building Permit Application
016
Plannl on 2
np d RnvelopnrencServkes MAR 7 .
dullding and We RepuWon D bion
2300 Wryinlo Avenue,Fort pierce FL 34982 /
Phone:(772)462-1553 Fax:(772)462-7.578 Commercial� Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: h
Legal Description: ('.li,tlo I.VB J10.3g..J, _
Property Tax ID#: 0051, DOD- Lot No.��
Site Plan Name: Block No.„
Project Name: 1 ln.l'h u(ne-r
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
sl
11 new 4 ton Le� � 1✓1 ifid, 261a%Hea 1ft?
KWh ►o w hQa C
OdGI PII,�d�8,X30-0� Air�rAC Q6 #C6,( 32AIV- 49
CONSTRUCTION INFORMATION:
AdLdVnal workorme under s perm —check a apply:
HVAC OGas Tank []Gas piping Shutters 1_L Windows/Doors
Electric El Plumbing Sprinklers Generator ED Roof
Total Sq.Ft of Construction: Sq.Ft.of First Floor:
Cost of Construction:$ -7ftOs 60 Utilities Sewer 1J Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Name•
Address: 14% v4ott b(. Company: it '(^ OY"hw C G•
City: Yoc 5t.Udly, State: Address:
Zip Code: Fax: City: state:.�L
Phone No. .�07— J�rI�O +�10`� _- Zip Code: 34451 Fax: " 2.2--qg:=
E-Mail: Phone No. -M A&I-4141
Fill In fee s mple Title Holder an next page(If dt(ferent E-Mail:
tram the Owner listed above) State or Co my License: WINES&
N value of constmction is$2500 or mmu,a RECORDED Notice of Commencement is required.
03/07/2016 14:53 7724663737 BOYLEAC PAGE 01
31-711
SUPPLEMENTAL CONSfRUCnON LIEN LAW INFORMATION:
DESIGNE ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address:. Address:
City State:- City: state:
Zip: Phone: Zip: Phone: ,.
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
-
Name: P Name-
Address: Address:
City: City:
Zip: Phone-. Zip:_Phone-
I certify that no work or Installation has commenced prior to the tvamnm of a permit.
1.We Count�mak no �tt on that is granting a it ll a t oadze the It hof to build the subject re
Ls In orlflla va er�pplkebleHome Owners Also rt rues,bylaws or a�covenantsts to a pro�such
structure, ease consuh your Name comers Association and realew your deed any r icn may pPil►
in consideration of the granting of this requested permit,l do hereby agree that 1 will,in all respects,perform the work
In accordance with the approved plans,the Florida Building Codes and Sc LudB C wnty Amendments.
The following building permit appllmdons are exempt from undergoing a full concurrency review.room additlons,
acwssory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to ancrthe r trarr•reddentlal use
WARNING TO OWNER:Your faihwe to Record a Nodes of Commencemeft may result In your payer"Wks for
Improvements to your property.A Notice of Commencement must be recorded and pasted on the jobsite
before the first Inspection.if you intend to obtain financing,consult with lender or an attorney before
commencing work or recording ur Notice of Commencement
r-
ature of Owner
,,rAgm
Lessffie Signature of[ontracEor/ticense Holder
STATE OF FLORI c �. COAUNTY OFTE OF ��,IQi
COUNTY OF
The fn aft krst ent was admowledged before me The fti3�� meet was admawledded before me
ft 7%day of 20 rW__by this da 'of 20 w'bN
BOAP 10
�V
( ame of person admov g) (Name of person admmW ng) .
(signature of Notary State of Florida) re of Notary bite§tm of Florida)
personally Known_Y r.OR Produced IdemtllIc atioe Personally Known OR Produced idanUfIcatlon
'type of Identification Produce:- TYPe of ldwMretion
Commission N :,, !'HRIATINE(Mqi`WF' Com ON
34
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