HomeMy WebLinkAboutBuilding Permit Application 3
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED _
Date: Permit Number: �1
RECEIVE®
Building Permit Application
Planning and Development Services SEP 0 q 1 2017
Building and Code Regulation Division PERMITTING
2300 Virginia Avenue,Fort Pierce FL 34982St. Lucie County, FL
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
:PROPOSED IIVhPRO.vEME,NTv.LOCATIO,N ,...:_
Address: 5600 HEMINGWAY CT D-04
Legal Description: TROPICAL ISLES (OR 2786-2163) UNIT D-04
Property Tax ID#: 3410-508-0081-000-8 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTIOWOF WORK. R,
p�f C n e out 10CkJ
CON'SULICTI'ON I`1NFORMATI0N
A�Iditional work toe e orme under this permit—check a appy:
HVAC E] Gas Tank DGas Piping _Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers 11 Generator E] Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction:$ 4499 UtilitiesSewer Septic Building Height:
OWNER/LESSEE" CONTRACTOR: e :"
Name Tropical Isles Co-op Inc Name: RICHARD LEVINSON
Address:281 Tropical Isles Cir Company: SERVICE AMERICA
City: Fort Pierce State:FL Address: 2755 NW 63RD CT
Zip Code: 34982 v
��2 Fax: City: FT LAUDERDALE State:FL
Phone No.J� 0 — � D-77'20 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.
S
SUP'PLEmV N.TAL CONS'RUCTION LIE:NIAW WFORMATION
DESIGNER/ENGI NEER: _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 Commen ent may result in your paying twice for
imprnetee
s to your property. A Notice of Commencement ust b recorded and posted on the jobsite
befost ' spection. If you intend to obtain financing, co s It w th I nder or an attorney before
com o k or recordingour Notice of Commencemen
I\" -'
\AU
s
Sign ee/Contractor as Agent for Owner Signature o or Lic se Holder
STATE OF FLORI A STATE 0 FLOR�pA
COUNTY OF Pmward COUNTY OF O MWOM
The forgoing instru ent was acknowledged before me The forgoing instr ment was acknowledged before me
this day of 1 ' 20 11 by this , day of 20 Z by
RCh2d Le&San
(Name of person acknowledging) (Name of person acknowledging)
I r
( ignature of Wotary Public-State of Florida) (Signature of otary Public-State of Florida)
Personally K goer-�°` ' �6� � cl46VVATTAtf'c
R
Personally KnownZp�ocll?LType of Iden ifPea njp;�y�MMISSION#FF9529Type of Identification F '' MY COMMISSION#FF957.984
W EXPIRES January 21,202Q + ,,
EXPIRES January 21,2020
Commission � u Se@4e'V"ecwn
GU7,4ay-0t53 Fluwi(t+Noiary5ei�$�e@i.� •, Commission No. �nn��s.a�u+5� Florid ,b
Revised 07/15/2014
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