HomeMy WebLinkAboutBuilding Permit Application 06/14/2016 12:42 7724663737 BOYLEAC PAGE 01
'ALL APPLICABLE INFO MUST Of COMPLETED FOR APpi.ICATION TO BE ACCEPTED
Date: Permit Number.
RECEP—D JUN 14 2016
Building Permit Application
Planning anddembpmentSen*es
Building and Code Regubtlon DimWon
2300 ftinlo Avenue,Fort Nerm FL 30V
Phone:(M)462-IM rax;(n2)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dmpbox, click amow at the and of lily
PROPOSED IMPROVEMENT LOCATION:
Address: I f R., S LA51
Legal Description: u.lc)ac� afILS l 7 t �LL4 i'S UT 2
r
Property Tax lD#: lO O - 3 -(�00 Lot No.
Site Plan Name: fN hnnms Block No.
Project Name,
Setbacks Front, Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
u
Ulu,fbr U ale - Ac c ch you. , 5 tarp 114 Seel`.
uvinox uof ►o Kwe .
Gid t�r>de� �►��cX-o4o-� 0, it Ran41V Rode[# 6ff>x26tkH--opo
CONSTRUCTION INFORMATION:
o wo 0ffe
orme under is perm -- e aMutters
apply:
HVAC as Tank Enlaas Piping _ t„_.i Windows/Doors
❑Electric Plumbing OSprinkler Generator Roof
Total Sq.Ft of Construction:_ _ S .Ft.of First floor:
cost of Construction:$ 5-700.dQ utilities:12Sewer[]Septic Building Height:
OWNER/LESSEE; CONTRACTOR:
Nam MMS Name;
Address: -� Company: (' .
City. - State: [h' Address:
Zip Code: I Fax. WA Mate:
Phone No.�7� 3 -- Zip Code: 59 Fax:,112- •, 751
PhonE-maie
zn-�1+�1� Qt7l.C�irY1 _ phone No�
Fill In fee simple Tide Holder an nsxt page I it different E-Mail.'
from the Owner listed above) State or County License: 19 1312 to
if value of Mnserucdon 15$2=or more,a PECMEo Nodoe of Coottmancament is required.
06/14/2016 12:42 7724663737 BOYLEAC PAGE 02
SUPPLEMENTAL CONSTRUCr1ON UEN LAW INFORMATION:
iNMb —Nat Applicable
Name: MOR'TGi�E CON�ANIh _Not Alsplicabk
Address: Name:
5��:� Address:
ZIP: Phone• W She:---
,,.,..,. Zip:,. _Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPAW. —Not Applii ible
Name: Name:
Address- Address:
Xlp Phone:
DP=�Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
5t.I�,�cle Courmano repte�tion that lsa�ndngamft will a�ortxe theft holder to build the su�ect�re
whidt cs M ct anY�pp a Home on rules, ora covemarrts at army restrict or
structure.Please c:onsuit[crit[your Home Owners Assodation and ne�vtewr your deed for any restrictions which may apply.
In consideration of the granting of this requested pennft.I do hereby agree that 1 will,in all respects,perform the work
In accordance with the apprwvd plans,the norift i3uliding Codes and St.Lucie County Amendments.
The feftwi cg building Penni[applications are exempt from undergo ft a full concurrency review:room additions,
aax ssoty%buctum swimming pools,fences,wails,signs,screen rooms and accessary uses to another mon-reskiential use
WARNING TO OWNER:Yotwfeilure tis Record a Notice of Commencement esu rtestrlt in Vow psft t:am for
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection If you intend to obtain finandnL consult with lender or an attorney before
commencins work or recordina your Notice of Commencement.
Sigmature of Owne,2LOW Lawee Signature of ConvactorAlcense
STATE OF FID STATE OF FLORIDA
COUNTY OFOFt.11a((2.
Iwo oing instrumentwas adutowkdged before n$me The�i"strumawas me
this dsy of�(�YIQ..� J 20 1+by this of T(.U'1 _ 20 W by
�dL[chQ�G , bol& Viii,Glad r Bo Ie..�
(Name of person admawl ng) (Name of person acknwM ng) .
A - a a&
o 62 I-ILiAw . 147
ignatum of Nota Publla Shiba of Florida) (Signature of State of RwWa)
PerSaeaOyKnown._.,L0R Produced Identification Personally Known-70R Produced mon
demifftxti
type of Ident3fkatien Produced 1Ype of Identifiratktr,Produced
Commission No. HRI8ft1 J COKWELL Commisskm No. UNP4$TINE WELL
AWA •• MY COMM=10N iF EE82MS ? •• MY OOMMMION a EES2848
1501 usi fi. id EXPlREB Auguel 21.2016
Revised 07/15/2ramw•s w�oce�
REVIEWS FROM ZONING SUPERVISOR PLANS VEGETATION SFATURTLE MANGROVE
COUNTER RSnEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLIM
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