HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: a`�� ti_J Permit Number:
• RECER"7D FEB 0 6 2117
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 X
PERMIT APPLICATION FOR: Plumbing
Address: 10044 S OCEAN DR UNIT 505,JENSEN BEACH, FL 34957
Legal Description: SEA WINDS CONDOMINIUM APT 505(OR 3789-2797)
Property Tax ID#: 4502-804-0037-000-9 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
:' q ,tt x F-^,r' x „=e t{ z'� a , + f 1 r ,.•' F '.i`+t^, •", �.. v s.'� fie'=
DETAD1,sESCRIPTIONO``i Ft WORKv FFx s� ,s ' r�' �� ° Z� � e< `°33 A�r ad} fean�'t
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CONSTRUCTIONIN#F®R`MATIONa
Additional.work toe ertormed under this permit—c6eck all appy:
HVAC as Tank []Gas Piping _Shutters Q Windows/Doors
Electric Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ a 00 Utilities:Sewer E]Septic Building Height:
OWNER%LESSEEy ;5s' ,; ; ' r {Cb NTRACTOR � 5}
Name ROBYN BATSON Name:--, in k r\ VA 4 a.r
Address:3 PALMETTO DR Company:Hv e
City: STUART State:FL Address: I SO\ 2on' !-As \9A
Zip Code: 34996 Fax: City:4r 54--k R' ecce. Stater�—
Phone No.954-553-1778 Zip Code: '3q lel Fax:
E-Mail:ROBYN.BATSON@GMAIL.COM Phone No.-1 -f44 S7-9 0 t4 0
Fill in fee simple Title Holder on next page(if different E-Mail: r I cl WYO
from the Owner listed above) State or County License:CVC Iy Y) RS Ga
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CO!NSTRU.CTION LIEN-,LAW INFORMATION:; .'.
DESIGNER/ENGINEER: x—Not Applicable MORTGAGE COMPANY: x Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable BONDING COMPANY: x Not 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 may apply.
In consideration of the granting of this requested permit,I do hereby agree 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
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 financing, consult with lender or an attorney before
commencing wo r recording our Notice of Comme me t.
s
Signature of Own L ee/Contractor as Agent for Owner Si ature of Contractor/Lice se Holder
STATE OF FLORIDA' `` STATE OF FLORID /
COUNTY OF c�'r �U-C c COUNTY OF KUCL -�
The for
oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 6 day of I=�br air h y 20 I this 16 E• day of FAr, r 20 L2 by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known�OR Produced Identification Personally Known_ OR Produced Identification
Type of Identificati nd Produced Type of Identification Produced
Commission No. FF ca o .9 •; } EDWARD 6tiimissi n No.FF Da 9 39 (Seal)
4•' Notary Public-St ite of Florida
My Comm.Expire Oct.8.2017
Bonded Through National Notary Assn. :r°`" •"s Not Public-Stale of Flori
Revised 07/15/2014 ='• •'i My Comm.Expires Oct.8,201
Commission#FF027328
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