HomeMy WebLinkAboutBuilding Permit ApplicationALL APPLICABLE NFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �Q o r
Date: Permit Number. ! LJ 1 .��
MOM 1111 ffi�lliP"Ill
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
I
PERMIT APPLICATION FOR: Plumbing
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PROPOSED IMPROVEMENT LOCATION: y;
'
Address: 9500 S OCEAN DR UNIT 1302, JENSEN BEACH, FL 34957
Legal Description: ISLANDIA II CONDOMINIUM UNIT 1302 (OR 3996-1157)
Property Tax ID #: 4502-602-0116-000-7 Lot No.
Site Plan Name: Block No. .
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK: ,
HVAC Li Gas Tank
17-
L Llectric ❑ Plumbing
Total Sq. Ft of Construction: 1200
Cost of Construction: $ 1500
under this permit — check all rhJ apply:
❑ Gas Piping_ Shutters
Sprinklers ❑ Gerierator
SFt. of First Floor: _
Utilities: Lr I Sewer []Septic
Windows/Doors
Roof Roof pitch
Building Height:
OWNER/LESSEE: =CONTRACTOR:
Name MOANA MANAGEMENT INC
Address: 3 PALMETTO DR
Name: :15 ; \
Company:
City: STUART State: FL
Address: 117;>_ay
Zip Code: 34996 Fax.
City: ? _ P •` e- State:—r<—
taterPhone
PhoneNo. 954-553-1778
E -Mail: robyn.batson@gmail.com-
Zip Code: 3Y a 'S (J Fax:
Phone No. ��a��-
Fill in fee simple Title Holder on next page ( if different
E -Mail:
from the Owner listed above)
State or County License:
va UC u! LunaaruLuun 1s .?zauu or more, a KtLUKutu Notice of Commencement is req
'SUPPLEME NTAL CONSTRUCTION LEEN 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:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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
commencing woa or recordipg your Notice of Commencement\
as Agent
STATE OF FLORIDA
COUNTY OF .IUCt C__
The forgoing instrument was acknowledged before me
this _Qe
Ldayof M&%f 20 by
(Name of peAon acknowledging)
SignatureCon ractor/Li
ST CIRIDA
COUNTY OF
The forgoing instrument
this rLt day of I'/
(Name of person acknowl
acknowledged before
---------- �20 In by '
e2 t 9
'U'B
- — � C — (Signature of Notary Public- State tatf Florida
(Signature of Notary Public- State of Florida
R Produced Identifica 00 Personally K ificat
Personally Known _kZO Known V' I OR Produced Ident i[0y,--
Type of Identification Produced, R �-ii —0 6 !j Type of Identification Produced
!3 f-
91
(Seat)
Commission No. FF0Lo Commission No.Fro9? 31Q31, (Seal)
Revised 07/15/2014
REVIEWS
FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION,
REVIEW
SEATURTLE
REVIEW
MANGROVE
I REVIEW
DATE
COMPLETE
INITIALS
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