HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: ST Permit Number:
�1 RECEIVED Mgt 0 8 2017
moomw 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: Mechanical
PROPOSED IMP.ROVEMENT�LOCATION:
Address: 10200 S Ocean Dr#203
Legal Description: ATLANTIS III BY THE SEA UNIT 203AND PRO-RATA SHARE IN COMMON ELEMENTS
Property Tax ID#: 4511-518-0011-000-1 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION O"O WORK:
C AC ChaV e o l 2.5 fvnS 1S . (f5 seer- 7S ICW�4
CONSTRUCTION]WORMATIO
Additionalwork toe e orme under this permit—check a appy:
HVAC E] Gas Tank DGas Piping F71_Shutters ❑Windows/Doors
0Electric ❑ Plumbing Sprinklers 1:1 Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 4692 Utilities: Sewer Septic Building Height:
OWNER/LESSEE:� , CONTRACTOR: _
Name Wells Richard&Terri Name: Richard Levinson
Address:10200 S Ocean Dr #203 Company: Service America
City: Jensen Beach State:FL Address: 2755 NW 63rd Ct
Zip Code: 34957 Fax: City: Ft. Lauderdale State:FI
Phone No.815-867-3445 Zip Code: 33309 Fax: 954-977-3591
E-Mail: Phone No. 954-979-1100
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:,
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 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
befor fi t inspection. If you intend to obtain financing, c It with lender or an attorney before
m
coe c ork or recordingour Notice of Commenceme
s
Si ature ne Lessee/Contractor as Agent for Owner Signator o rbcto /License Holder
STA E OF FLORIDA / ST44"E OF FLORID
COUNTY OF ��oc+xtr�? COUNTY OF ro�c�r�
The for oing instr me was cknowledged before me The forgoing instr me was acknowledged before me
this day of 20 n by this "17) day of �G1L 20 i� by
RICHAR LEVINSO RICHARD L SON
(Name f perso knowled ' at•c• Sheneka Hardy (N e o erson ackn
� a, Sheneka Hardy
i Notary Public-State of Florida a Notary Public-State of Florida
Commission#GG3380
s. Exnires 9/27/2020 r < Commission#GG 33870
(Signa�;rof otary ublic- natur of No ary P b � a of Florlijes
Person Ily Kno Produced Identification ersonQc OR Produced Identification
Type of I ificati oduced Type of Identification Produced
Commission No. (Seal) Commission No. (Seal)
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS