HomeMy WebLinkAboutBuilding Permit ApplicationADatePPLl�i j.E� INF � �T BE COMPLETED FOR APPLICATION TO BE ACCEPTED � �� ��
I Permit Number:
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: Plumbing
PROPOSED IMPROVEMENT LOCATION
Address: 9421 S OCEAN DR
Legal Description: ISLAND VILLAGE PHASE II BLDG 7 UNIT 91
Property Tax ID #: 3535-333-0001-610-1 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK.
Exact Maley Harter Chan3e omi 40 19C 16-1 e
DNSTRUGTION INFORMATION:
Jditional work toe e orme under
❑_ HVAC Ei GasTank
Electric ✓❑ Plumbing
Total Sq. Ft of Construction:
Cost of Construction:
us permit — check a appy:
]Gas Piping Shutters
]Sprinklers FIGenerator
S Ft. of First Floor: _
Utilities:D Sewer[] Septic
]Windows/Doors
Roof Roof pitch
Building Height:
t yR
OWNER/LESSEE s ry
CONTRACTOR:
Name Robert A Mangine Jr
Name: Allen Steinman
Company: Service America
Address: 2755 NW 63rd Ct
Address: 25 Locust PI
City: S Huntington State: NY
Zip Code: 11746 Fax:
City: Ft. Lauderdale State: FL
Phone No. -7-7Z- — 00q--1;;)�90
Zip Code: 33309 Fax: 954-977-3591
E -Mail:
Phone No. 954-979-1100
E -Mail: epermitsgroup@serviceamerica.com
Fill in -fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License: CFC057026
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
•SUPPLEMENTAL.CONSTRUCTION LIEN LAW+ INFORMATION: = .
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: - State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
BONDING COMPANY: _Not Applicable
Name:
Address:
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
commencintz work or recording vour Notice of Commencement.
Sign atur f Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA /
COUNTY OF
apt��__ s
Sig t f Contractor/License Holder
STATE OF FLORIDA
COUNTY OF �roc��r�
The former n instWrl
t wa acknowledged before me The forgoing instruent w s.acknowledged before me
this 1 �r"day of 20 �7 by this 12 day of Tf r/ 20 17 by
(Name f perso acknow dgja&) (Na of a)son ac owledging )
of Notary
Type of Identification
Commission No.
Revised 07/15/2014
lic- State of Florida )
Sheneka Hardy
Notary Public -State of Florida
Const a$)on#GG33870
Expires 9/27/2020
Public- State of Florida )
Person14 KnoWn X
Type of Identification
® Notary Public - State of Fler
Commission No. r. o` COA%Mlln#GG3387t'
lFo: F�o� Expires 9/27/2020
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