HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE INFP MU T BE COMPLETED FOR APPLICATION TO BE ACCEPTED•
Date: Permit Number:
La
y` Building Permit Application
Planning and DevelopmentServices
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residlential X
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 95.00 S OCEAN DR UNIT 1302, JENSEN BEACH, FL 34957
Legal Description: ISLANDIA II CONDOMINIUM UNIT 1302 (OR 3996-1157)
4502-602-0116-000-7
Property Tax ID #: i Lot No.
Site Plan Name: i. I Block No.
Project Name:
i
Setbacks Front Back: Right Side: Left Side: I
i
DETAILEDD:ESCRIPTION OF WORK: -
I CONSTRUCTION INFORMATION .�,
Adclitional work to be
ve orme under this permit -check a a appy:
HVAC EJ Gas Tank ❑Gas Piping L_ Shutters F]Windows/Doors
Electric ❑ Plumbing Sprinklers E Generator El Roof Roof pitch
I
Total Sq. Ft of Construction: 1200 VFt
of First Floor:
Cost of Construction: $ 1500 UtilitieSewer F]Septic Building Height:
QWNER/LESSEE:
CONTRACTOR:
Name MOANA MANAGEMENT INC
Address: 3 PALMETTO DR
Name: a +J 01Ju ct r-
117
City: STUART State:F
Zip Code: 34996 Fax:
Phone No, 954-553-1778
City: P-±_ S -F e �State:j= �-
Zip Code: 3 C-('� S� ; Fax:
Phone No. %743f10,5V/ 3
E -Mail: robyn.batson@gmail.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
t-'
E-Mai1:3Q_ -%(N 0.i" @ O%Sf�ir— SSS ms PC
State or County License: ; (Z- 1 f)$�L_
I CONSTRUCTION INFORMATION .�,
Adclitional work to be
ve orme under this permit -check a a appy:
HVAC EJ Gas Tank ❑Gas Piping L_ Shutters F]Windows/Doors
Electric ❑ Plumbing Sprinklers E Generator El Roof Roof pitch
I
Total Sq. Ft of Construction: 1200 VFt
of First Floor:
Cost of Construction: $ 1500 UtilitieSewer F]Septic Building Height:
QWNER/LESSEE:
CONTRACTOR:
Name MOANA MANAGEMENT INC
Address: 3 PALMETTO DR
Name: a +J 01Ju ct r-
-
Com any:Go d
. s e t 2- f_.
Address: �� l .5 W I✓v�otF�e 5 t
City: STUART State:F
Zip Code: 34996 Fax:
Phone No, 954-553-1778
City: P-±_ S -F e �State:j= �-
Zip Code: 3 C-('� S� ; Fax:
Phone No. %743f10,5V/ 3
E -Mail: robyn.batson@gmail.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
t-'
E-Mai1:3Q_ -%(N 0.i" @ O%Sf�ir— SSS ms PC
State or County License: ; (Z- 1 f)$�L_
IT vaiue oT construction is >tsuu or more, a RECORDED Notice of Commencement is required.
SUtFlEMElNTA1 CONSTRUCTtOtV t:iEN LAVH t�1Ft3RMATtt?N
FRONT
DESIGNER/ENGINEER: x Not Applicable
Name:
MORTGAGE COMPANY: x� Not Applicable
Name:
Address:
Address:
City: I State:
Zip: Phone: i
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
BONDING COMPANY: x Not Applicable
Name:
Address:
Andress:
City:
City:
Zip. Phone:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Counter makes no representation that is granting a permit will authorize the permit holder tolbuild the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants thatimay 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 accessoryuses 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 arj attorney before
commenchm-Vinik or.recordine your Notice of Commencement.. /I /l
tractor as Aeent for Owner
STATE OF FLORIDA�^ j SIATE OF
COUNTY OF 12- At/CI Q I COUNTY I
The forgoing instrument was acknowledged before me The forgoing instrunaent was acknowledged be
this ZqL day of _ MAS _ 20 ��+ � 4- this day of ,� ( A 20
( ��+..
acknowledging)
(Signature of Notary Public Jstate of
Personally Known 1,,o'_ OR Produced I
Type of Identification Produced
Commission No. ff-�Q.—�.D
Revised 07/15/2014
-'' 10 h ft [ °city y k �!
(Name of person acknowledging)
CL
5 Q_ r 10111 I1 f
o,g
�Ogg
aD
{Signature of NotaryPPuublic- State of Florida )
taw+ Personally Known " OR Produced Identification
Ir O Type of Identification Produced
9 SL C1
°"'� x Commission No. �F Seal
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
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MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS
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