HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Date: "7"'• ,2 �' �� Permit Number:
Building Permit Application
Planning and Development Services APR 2 8 2017
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: Mechanical
PROPOSED IM'PROVEMENTLOCATION:.,"-
Address:
OCATION Address: 5820 Spanish River RD
Legal Description: PORTOFINO SHORES-PHASE TWO-(PB 43-33) LOT 40
Property Tax ID#: 1312-502-0047-000-3 Lot No.40
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED.DESCRIPTION OF,V1/ORK
Exact AC ehogq e oc tt 3. r_-D -hD n )/+ s 10 ICU
CONSTRUCTION INFORMATION:
Additional work toe e orme . under tispermit—checka appy:
HVAC Ei Gas Tank E]Gas Piping _Shutters ❑Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 4867 Utilities:cnSewer Septic Building Height:
bW_;NER/LESStE "CONTRACTOR:_
Name Guido Louis&Genevieve Name: Richard Llevinson
Address:5820 Spanish River Rd Company: Service America
City: Fort Pierce State:FL Address: 2755 NW 63RD CT
Zip Code: 34951 Fax: City: Ft. Lauderdale State:FL
Phone No.772-489-7671 Zip Code: 33309 Fax: 954-977-3591
E-Mail: Phone No. 954-979-1100 EXT 5673
Fill in fee simple Title Holder on next page(if different E-Mail: epermitsgroup@serviceamerica.com
from the Owner listed above) State or County License: CAC014619
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SU�PnPLEMENTAL�COIVSTRIJCTION EN LAW IN�FORMATION�
a�
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: 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 thepermit 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 unoing a full concurrency review: room additions,
accessory structures,swimming pools,fences,walls,signs,scr en r oms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure-t Record a Notic of Co a cement may result in your paying twice for
mArehie
ents to your property. A Notl f Comm nceme m t be recorded and posted on the jobsite
first inspection. If you intend to o ncing cons It with lender or an attorney before
in work or recordingour Notice of nt.
s
Sign ,ofGwn - /.Contractor-as-Agent for-Owner-tjSi tur-e=of=Con r-/license:Ho�(dery
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ocva� COUNTY OF ►�OwQr'
The forgoing instr e t was cknowledged before me The�fo�r"gw oing instr nt s acknowledged before me
this�day of 6 1 20 17 by this LlJ day of i 20 J7 by
RICHAP4 LEVI N RICHA D LEVI S N
(Nam of pers ackn edging) (Nam of per n ackno edging)
(Si at re�Naryic-State of Florida) ( I ature o Notary ublic-State of FloridaPersonaP Identifica Ion se
Known X 0
Type of Identification Produ e, shenek�Hardy Ty e of Identification Produc d �Pa`° ShPndka Hardy
ivataryu is-St�lo ida 2 S NotaryPublic-StateofFlori
Commission No. Ns. �`Sea1 mmisslon#GG 3387 C mmission No. m oc(S�r)nmission*GG 33870
' Expires 9/27/2020 C. � Expires 9/27/2020
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS