HomeMy WebLinkAboutBuilding Permit Application 21 s-
ALCAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED C}
Date: Permit Number: ! �N (/qc/ /
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: To Select from dropbox, click arrow at the end of line
'PROPOSED IMPROVEMENT LOCATION:- .-:.. �4
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Address: 7380 S OCEAN DR 522 j
Legal Description: DUNE WALK BY THE OCEAN a/k/a SAND DOLLAR NORTH BLDG A UNIT 522
Property Tax ID#: 3522-607-0030-000-4 Lot No.
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Site Plan Name: Block No.
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,Project Name:
Setbacks Front Back: Right Side: Left Sidef
6E! I'LED'DESCRIPTIONbF WORK
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CQNSTRUCTION INFORMATION ' I i'
Additional work to be nertormed under t ispermit—check k a appy: I
HVAC Gas Tank E]Gas Piping _Shutters ❑Windows/Doors
❑_Electric 0 Plumbing []Sprinklers ❑Generator ' ❑_Roof Roof pitch
Total Sq. Ft of Construction: S3961 . Ft. of First Floorl
Cost of Construction:$ Utilities: _Sewer❑S i ptic Building Height:
OWNER/LESSEE CONTRACTOR
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Name Deborah A Lucas Name: Richard Levinson
Address:172 Driftwood Dr Company: Service America
City: Oneida State:NY Address: 2755 NW 63rd Ct
Zip Code: 13421 Fax: City: Ft Lauderdale State:FL
Phone No.315-269-6357 Zip Code: 33309 Fax:
E-Mail: Phone No. 954-979-1100
Fill in fee simple Title Holder on next page(if different E-Mail: eppermitsgroup@serviceamerica.com
from the Owner listed above) State or County License: CAC014.619
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CQNSTRUCTION LIEN LAW INFORMATION: '.
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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: I
City: City:
Zip: Phone: Zip: Phone:
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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,
I accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARN( G TO OWNER:Your failure to Record a Notice of Commen t may result'in your paying twice for
impro nts to your property. A Notice of CommencementAnI
t b re orded and posted on the jobsite
befor th irst inspection. If you intend to obtain financing, ct th ender o'r an attorney before
com enc n w k or recordin our Notice of Commenceme
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Signatur ner/Less a/Contractor as Agent for Owner Signature tractor/L ense Holder
ST E OF FLORIDA 1 ATE OF FLORIDA
COUNTY OF ?)IfpuM(� COUNTY OF
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The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this9l day of AL(Ql f ,'�t20 Eby thisLL day of At 16U--, 20 L by
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(Name of person acknowledging) (Name of person acknowledging)
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(Signature of Notary Public-State of Florida) (Signature of Notary(Public-State of Florida)
Personally Known i , OR Produced Identification Personally Known t/ OR Produced Identification
Type of Identification Produced Type of Identificationl Produced
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Commission No.C�T1 1 Seal)- Ca=ission No. GG`�5��' �pRY P al) Kimeko Allen
KlmekoAllen i, � NotaryPublic-Stateof rida
ission#GG 7 1
1N.10 yPublie-Steleell -- --
N� a` Commission#GG 75771 �r o� Expires 2122/202
Revised 07/15/2014 FOFFt
91
pFFExpires 2/22/2021
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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INITIALS
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