HomeMy WebLinkAboutBuilding Permit Application 08/18/2016 10:12 7724663737 BOYLEAC PAGE 01
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ALL APPLICAqUINFO MUST BE COMPUTED FOR APPLICATION TO BE ACC "W
Date: d' OS66
Permit Number:
LIMULEEM CUE
Building Permit Application
Planning and Development Services AUG 16 2016
8ulld/ng land Code ReguhWan Dh Lwn
2300 Virginia Avenue,fort Pierce FL 34882
Phone:(772)462-1553 Fax:(772)462-1578 Commercial ResidentialV�
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of fine
PROPOSED IMPROVEMENT LOCATION:
Address: r
Legal Description: -
()
Cl
Property Tax ID#: 56 1t 5 g. 000 3 Lot No.
Site Plan Name: Block No.
Project Name:
_5JO Wan
Setbacks Front Back: Right Side: ^Left Side:
DETAILED DESCRIPTION OF WORK:
I�fK ' Uke'' - wx -fov►, la's seer, eat,
1,6� se+r IUadel C �Cx5D36 - z3d /fir ktandf� Cu�suK�o
CONSTRUCTION INFORMATION:
a worktorformed under tnis permit-cheCk checkall appy:
HVAC Gas Tank Gas Piping Shutters Wlndows/Doors
❑Electric Q Plumbing 05prinklersGenerator Roof
Total Sq.Ft of Construction:...__. .. _ Ft,of first Floor:
Cost of Construction: _U001�0 __ _ Utilities 0Sewer FiSeptic Building Height: _
OWNER/LESSEE: CONTRACTOR:
Nam h Name: si Lo
Address: 131-VA, Company:
City:JbA2if(6 -_._._. . State: Address:
Zip Code:. 345( Fax: PJ]A City: Ol �ce)QQ. �_,._ state:_____
Phone No.. -9 AN- 4p,Code: 3q451 Fax:1w` 6-17 7
E-Ma4"p—le
Phone No. I
fill In Title molder on next page(If different E-Mail:
from the Owner listed above) State or County license: Ct !
If value of wnstructloe Is$2500 or more,a WORM Malice of Cmnmencement is required.
08/18/2016 10:12 7724663737 BOYLEAC PAGE 02
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNS ENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State.• City: State:_
Zip: Phone:--- .„ Zip: Phone:
FEE SIMPW THU HOLDER: � Not Applicable BANDING COMPANY: _Not Applicable
Name` Name:
Address- Address:
City: city:
Zip: _.�. Phone: Zip: Phone:
1 certify that no work or Installation has commenced prior to the Issuance of a permit.
5t.Lde Cou makes no representstlon tts4 Is granting era �mit 11 orize the holder to build tete
which is In ' d with Any applicab��ee Home owners on as, awa ora�r covenants moo, dor roam udt
structure.Please consult with your Home Owners Association and review your deed d y rrsrridOns wh�mrry a�piy.
In consideration of the granting of this requested permit,I do hereby agree that I will,in aff respects„perform the work
In acc ordante with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The fnilowing building permit applications are exempt from undergoing a full tonwrtency review:room additiorw,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accr9wry uses to another non-rWdentlal use
WARNING TO OWMER:Yaw failure to Record a Notice of Cmumx t ment may result In your pragft twom for
Improvements to your property.A Notice of Commencement mast be recorded and posted on the jobsite
before the first ins' lion.If you Intend to obtain financing,consult with lender or an attorney beforecommencing work or recogligglaur.Notice of Commencement.
Signature of Own?fAgeny Lessee Suture of Cemitrwitor/1.1censE Holder
STATE OF FLORI STATE OF FLORIDA `
COUNTY OF7 U,e VPi _..__. COUNTY OF V 1
The forgoing Instrument was acknowledged before me The forgoing In neat was adawwledged before me
this dry of AC( ( , 20 X by this daV of 20 by
it Q C3ov1
Mike[ f 5'IP�
(Name of person adcn edging) (Name of person adm edging) .
(Signature'of N Publ of Fksrldg) (Signature of Notary -Statae of Florida)
Personally Known OR Produced Identification Personalty known OR Produced Identilicatlon T
Type of Identification Prod TyrigoLickotillcalljoia
t luia11N1 , L iNYJktL CHIIISYINE J CONNIELL
Commission 2 �� Notar
public G 1?loilda is a1 Flor i)
• Commission w Iiti 411639 Commission N as 011939
1 urtirts Ex nes Aug 21.2020
6ondad tM Naponal
War
���� 110ndad lhiouph National Notary ASU.
Revised;0
REVIEWS FRONT ZONING SUPERVISOR PLANS VFGFTATION SFA TURTLE MANGRDVF
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS