HomeMy WebLinkAboutBuilding Permit Application Mar. 7. 2016 2:02PM Litchfield Co. — -Murrells Inlet No, 1298 P. 2
ALL APPLICABL INF `M/U�ST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: l U Permit Number: �J
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 �^
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow st the end of line
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Legal Description:
Property Tax ID#: no by C) 0 b - Lot No.
Site Plan Name. Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
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ACICIltional Work to be gertormecl un er t is permit—c ec a appy:
❑HVAC Gas Tank [:]GasPiping _Shutters Windows/Doors
®Electric 0 Plumbing Sprinklers Generator ❑Roof
Total Sq.Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$�, Utilities:n Sewer Else.ptic Building Height:
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Name 0*f Name ilov ^
Address:_'ql_Z�_ V Company:6�d VV 1-
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City: f (�u� _ F State: Address:
Zip Code• 3 r1 QFax: City: Stater-
Phone No. ✓ '� 3 I �" Zip Code: 1 Fax:
E-mail- Phone No. 0, C� t`
Fill in fee simple Title Holder on next page(if different E-Mail: rim) S liC QYTv�,
from the Owner listed above) State or Colinty License:
if value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
Mar, 1, 2016 2:03PM Litchfield Co. — Murrells Inlet No. 1298 P. 3
3i eNl' 4L�te MRRI .5•U•P Lc ,+ , •a t I.'G2®; A1 YN
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: V IState- City: V I 'State:
Zip: Phon Zip: Phone:
FEE SIMPLE TITLE HOLDER; _Not Applicable BONDING COMPANY: ,� t 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 map apply.
In consideration of the granting of this requested permit,I do hereby ag-•ee that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St-Lucie 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
improveme its to your property.A Notice of Commencement must be recorded a d posted on the jobsite
before the I irst inspecdo . If you int to obtain financing, consult with lender an attorney before
commencin 7 work or recqrdi.ng VouyNotice of Commencement.
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_Signatu Owner a gent glriatu Contractor/Licens of
STATE OF FLORIDA STATE OF FLORIDA
COUNTY CIF COUNTY OF•
The fing instrument w s acknowledged' fore me The f Ding instrument was acknowledged efore me
this or Dday of 20 „-by this day of 20 by
1
(Nam of personck wieiigIng) (Nam• of e
AN ARTINEZ
� E it1EZ
A A _ A C AI N�FF039952
N �2 I '� _�.: Jul' S.2017
Initure of Nota --$a (Signature*,NQ y ft -6 &WGl .4om
Personally Known entification Personally Known OR Produced Identification
—
Type of Identification Produc cam, Type of Identification Produced
Commission No.�n �1 (Seal) Commission No. (Seal)
Revised 07/15/2-014 -
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW • REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS