HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:� Permit Number:do-
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RECEP 'D JUL 172017
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 _ t-Ordv
PROPOSED i'IVl-PROVENI.ENT LOCATION
Address: 3880 N A1A 503
Legal Description: HIBISCUS-BY-THE-SEA CONDOMINIUM BLDG 2 UNIT 503 (OR 1241-2935)
Property Tax ID#: 1423-805-0080-000-7 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION .OF.WORK ;
-
C Chan e Lo of 4 t1,5- 13•(l Seer
CONSTRUCTION INFORM'ATIOU
s
Additionalwork to be ertormed under tispermit—c ec �all appy:
HVAC Gas Tank []Gas Piping _Shutters Windows/Doors
11 Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ r UtilitiesSewer 0Septic Building Height:
OWN'E'R/LESS`EE „ CONTRACTOR:
a
Name George Martin Name: RICHARD LEVINSON
Address:3880 N AIA Apt 503 Company: SERVICE AMERICA
City: Fort Pierce State:Fl Address: 2755 NW 63RD CT
Zip Code: 34949 'Fax: City: FT. LAUDERDALE State:FL
Phone No.772-468-6066 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@servicesmerica.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,INFyORMATION:' ; - -
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 first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording our Notice of Commencement.
(�H �_l s
Signature ee/Contractor as Agent for Owner Signature o ontractor/License Holder
STATE OF FLORIDA STATE OF FLOIADA
COUNTY OF 1c m rd COUNTY OF `,1 Xi rd
The for oing instr ment was acknowledged before me The forgoing instrument was acknowledged before me
this T day of 1_ 20tZby this itJ T day of JCJ k 20 JIL by
(Name of person ackno I �� ime o en (Name of person acknowled i I Kime : crid
al
Notary Public-State of Florida — ai 0 NotaryPut
°c Commission#GG75771 °c comm" 51771
o e` Expires 2/22/2021 �•��$lo�_ E'. "1
(Signa tur u - a e o ori a)-- (Signature of Notary Public- e or7oriBaj�r
Personally Known Z OR Produced Identification Personally Known_ ge�uced Ideifa�icn
Type of Identification Produced Type of Identification Prod e � - -
c _ or,�GG75771
Commission No. (Seal) Commission No. �. ��° (Seal) :22,L021
OFFL
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS