HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �a� 11 Permit Number: \?- a
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Building Permit Application 1 CEC
Planning and Development Services
Building and Code Regulation Division BY: .......................
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Mechanical - C o r c\�
PROPOSED IMPROVEMENT LOCATION:
Address: 10200 S OCEAN DR 304
Legal Description: ATLANTIS III BY THE SEA UNIT 304AND PRO-RATA SHARE IN COMMON ELEMENTS(OR 750-1148;3835-2614)
Property Tax ID#: 4511-518-0022-000-1 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front_ Back: Right Side: _ Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
Additional work to be oertormed under this permit-check all appy:
Z✓ HVAC Gas Tank []Gas Piping _Shutters ❑Windows/Doors
11 Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction: $ 4116 Utilities:0Sewer 0Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Natale Bozzo Name: RICHARD LEVINSON
Address:1559 GOLDMAR DR Company: SERVICE AMERICA
City: MISSISSAUGA State:on Address: 2755 NW 63RD CT
Zip Code: L4X 1N6 Fax: City: FT LAUDERDALE State:FL
Phone No.647-220-9963 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.
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SUPPLEMENTAL CONSTRUCTION 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 first inspection. If you intend to obtain financing, consult with lender or an attorney before
comnWcing work or recording our Notice of Commencement.
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Signature of Own /Lessee/Contractor as Agent for Owner ur of ontractor/License Holder
STATE OF FLOR A STATE OF FLORIDA
COUNTY OF �trE� COUNTY OF '3troll.,XA �
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 1� day of L-2.C.. 20 0—by this Z-+—day of 20 1-7 by
RICHARD LEVINSON RICHARD LEVINSON
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public-State of Florida ) (Signature of Notary Public-State of Florida)
Personally Known '/ OR Produced Identification Personally Known Z OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. 1 Y (Sf{d4jekoAllen Commission No. PFS ° eal) KimekoAlten
f0 NotaryPublic-State of Florida z� = NotaryPublic-StateofFl ida
VIVOion#GG 75
?,s o' Expires 2122/2021 \_� r ``� Expires 2/2212021
Revised 07/15/201 °`FL
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS