HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: hao �' � J
Permit Number:
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- Building Permit Application JUN a y 2017
Planning and Development Services
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Building and Code Regulation Division Lucie
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°I• Lucie2300 Virginia Avenue,Fort Pierce FL 34982 County, FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Mechanical
PROPOSED IIVIH MEMENT Lb AT!O°IV
Address: 9610 Knollwood Ln
Legal Description: MONTE CARLO COUNTRY CLUB-UNIT THREE- LOT 47
Property Tax ID#: 1327-701-0017-000-1 Lot No.47
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED'DESCRIPTI`ON 04F WORK
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Additionalwor to e e orme un e
r this permit—checka appy:
HVAC be
Tank
Gas Piping _Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 4483 Utilities:'nSewer 0 Septic Building Height:
OWN ER/LESSEE ;CONTRACTOR,
Name Carla S Cunningham Name: Richard Levinson
Address:9610 Knollwood Ln Company: Service America
City: Fort Pierce State:FI Address: 2755 Nw 63rd Ct
City: Ft Lauderdale State.FI
Zip Code: 34951 Fax:
Phone No. 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.
SU'PPLE�MENTAL'CO.NSTRUCTION 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 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 ' st insilpection. If you intend to obtain financing, Sult ith lender or an attorney before
commen n ork r recordingour Notice of Commence nt
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Sig ture Ow r/ see/Contractor as Agent for Owner a of Con ctor/License Holder
STATE OF FLCtRT0_0k,_> P STATE OF FLO�tD�
COUNTY OF ��►'�� —� c COUNTY OF
The f going instr t was acknowledged before me The forgoing inst ent was acknowledged before me
this day of Un e 20 17 by this 8 day of 00 2 20 i7 by
Irl► C� LCA r�sort I G v n 5011
(Na a of persoInmArlo (Na a of perso a
o�Aat P. < Sheneka Hardy o PRt A� Sheneka Hardy
C Notary Pubic-
State of Florida ® Notary Public-State of Florida
Commission#GG 33870 a Commission#
(Sign re of -kbbte ofFV@ir(d@0:27/2020 Sign re o t ry B ate oflF4PftWa9)'27/2020
Prsonally own R Produced Identification Pe onally ow OR Produced Identification
T of Ide uced Typ of Identi I roduced
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