HomeMy WebLinkAboutBuilding Permit Application 06/14/2016 14:07 7724663737 BOYLEAC PAGE 02
ALL,APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1 Permit Number:
Building Permit Applicati®n JUN 14 2016
P.%rmhgand Developmentkvkes Fci??JiIT iNG
Building and rode Regu►aWnDMs m '�L Luci aunty, FL
2300 Virginia Avenue,Fort Plarce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropisox, dick arrow at the end of liras
PROPOSER IMPROVEMENT LOCATION:
Address: !
Legal Description: 6_AW11jnnd POL( LOTS
Property Tax ID i►: Opp Lot No.
Site Plan Name: ( ant Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
4br Lt U IC Chanit-oullt 2• n i t nax
Coad om
K40&( 10. 14AC�(6030"7,10,j >ir Rader MOM W,892-5a,14-OW
CONSTRUCTION INFORMATION:
_-Adiditiope work orm unde s erm -c e aithatappy:
HVAC Gas Tank Gas Piping Shutters [1Winder/yrs
Electric Plumbing Sprinklers :J Generator Roof
Total Sq.Ft of Construction, ,r� S .Ft,of First Floor:w _—
Cost of Construction:$ 3 00. 00 Utilities:
sewer Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name Name:
Address•• 0 V
Company:
City:
f� State: - Address•
Zip Code:_ 1 Fax., City: �bf �l��r'CCQ� State:
Phone No. 912-M Zip Code:_144t?,if Fax• l�- a-v7t
E-Mail: MIA Phone No.
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or cou ty Ucense:�l -
9 value of can>m'uction is$a50Q lir mora,a RECORDED Notice of Commencement Is raqu red.
06/14/2016 14:07 7724663737 BOYLEAC PAGE 03
SUPPLEMENTAL CONSTRUCTION UEN LAW INFORMATION:
MSiGN ENGINEER: _Not Applicable RWRTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State•
Zip: Phone• Zip:_Phone: T
FEE SIMPLE TITLE HOLDER: _Not Applicable BONWNG COMPANY: Not Appllcable
Name; Name:
Address: Address;
City: cloy:
zip. Phone: Zip: phom:
i cerrftthd no
wov�kecor installation has commenced prior to the issuance of a permit
ich is bmnttl with a Homeet0 mersgAssaon Reis,�a j�ran�aohtder to s rbraaiki theC¢�ured3
structure,Please milt your Home Owners Association and review your an j resVkdm Whicha�Iy.I
In consideration of the granting orthis requested permit,I do hereby agree that l will,In all respects,perform tree
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 conwrrency rwAewa:room additim,
accessorystructures,swimming pools,fences,walls,signs,screen rooms and ammary uses to another non-reddentlat use
WARNING Tn OWNER:Your billwe to Record a Nodce of Cenrtraencemerat my result In your p WAw for
Improvements to your ppropco
erty.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 Imre
commencing work or recordft Mr Notice of Commencement.
Signature of Own sgpature of Contractor/Li older
STATE OF FLORIDA STATE OF R RIDA
COUNTY OFA COUNTY OF
The fbMoft Instrument was admmWwked before me The fanpft instm meant was admawlefted before mix
thla day of 14111 by thisY of J=. m—W bV
I� �
•L {
(Name of person admowledgin ) (Name of permtaawl
(Signature of Notary nc- a of Florida) (Signature of Nota ouIc-State of Florida)
Personal Known Produced ldentificstian Per&tanauy Krrowra OR Produced ida:raei0�tioia
Type of Identification Produced Type of Identification i induced
Commission No. Commission No. (Seal)
0ZLCHRISTINE J CONW9LL CH
11181111111.1 CO- 6
EXPIRES August 21,1016 •_ MY COMMiB8i0N a ELa2W2®
Revised 07/1 , , itseurga,ar 2t. tie
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIFW REVIEW REVIEW REVIEW
DATE
COMPLETE
L
ITIALS