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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 1011212017 Permit Number: � 7 1 V-O�_I_'�
Elam. I» RECEIVED
Building Permit Application OCT 12 2017
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fart Pierce FL 34982
Phone:(772).462-1553 Fax:(772)462-1578 Commercial Residential xxxxxxX
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
Address: 10701 S.OCEAN DRIVE LOT 860 JENSEN BEACH FL.
Legal Description: VENTURE OUT AT INDIAN RIVER INC LOT 860(OR 1308-2117)
Property Tax ID#: 4511-51MO61-000-2 Lot No.
Site Plan Name _ - ___��, Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
RELPAC_ E-3-T_ON PACKAGE A/C WITH 10 KW HEAT LIKE FOR LIKE
OEM=
zona wor toWnoWrme11n t is perm t cIffickrapply:�_HVACGas Tank Gas Piping s Windows/Doors
OElectric El Plumbing Sprinklers Generator Roof Roof pitch
Total Sq.Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 1500.00 Utilities:El Sewer n Septic Building Height=
Name PATRACIA MURRAY Name: LEONIDAS J DEMOPOULOS
Address:10701 S OCEAN DR LOT 860 Company: SUPER COOL OF THE TREASURE:COAST
City JENSEN BEACH State:FI. Address: 2156 SE HERRON AVE
Zip Code: 34957 Fax: City: PORT ST LUCIE State:FL
Phone No.913-638-1254 lip Code: 34952 Fax: 772-335-4912 -
E-Mail: Phone No. 772-8797113
frill in fee simple Title Holder on next page(if different E-Mail: SUPERCOOLSERVICE@GMAIL.COM
from the Owner listed above) State or County License: CAC 042650
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
DESIGNER/ENGINFER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE FOLDER: _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.
lgnature of Owner/Lessee Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA Jj , STATE OF FLORIDA
COUNTY OF {�j t71� _-- _ __-- COUNTY OF N
The forgDing Instrum t was acknowledged before me The forging Instrument was acknowledged before me
this�tCday of� J 2007-by this 2Zday of ,.S we, 20 ,:,by
(Name of person acknowledging) (Name of person acknowledging)
t ,
i
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personal/ Known OR Produced den ification Personal) Known Y � y _. AR Produced Identification
Type of Identification produced 1V Type of identification Produced Ro-,, L
Commission No. 4 US01 ) A5 17-Sol (Seal)
(seal) Commission No.
Revised 07/15/2014 �� aD411
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
rDATE
COMPLETE
INITIALS