HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
i1 1 a- ps94
Date: Permit Number: i; f
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
PROPQSED,IMRROVEMENT�LOCATIQN`
Address: 10200 S OCEAN DR 303 i
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Legal Description. ATLANTIS III BY THE SEA UNIT 303AND PRO-RATA SHARE IN COMMON ELEMENTS(OR 377-2707;3740-1861)
Property Tax ID#: 4511-518-0021-000-4
i Lot No.
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Site Plan Name: Block No.
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Project Name:
i Setbacks Front Back: Right Side: Left Side: 'I
DETAILED DESGRIP_TION:OF WORK
C AC DrLr) e OU+ c) fio� Iy seer :5
CQNSTRUCTI'ON INFORIVIATI.ON
1itiona workkto e�nerformed under this permit—check all that appy: I
W1HVAC Gas Tank []Gas Piping Shutters `i:
I Windows/Doors
0 Electric Plumbing []Sprinklers Generator Roof Roof pitch
i 1,
! Total Sq; Ft of Construction: SFt.of First Floor:
Cost of Construction:$ 3961 Utilities: _SeweY Septic i' Building Height:
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`CQNTRACI"OR G•' iI .� : r:
OWNER/LESSEE F
i Name Moretti Giuseppe&Elvira Name: RICHARD LEVINSON
Address:3058 GOLDEN ORCHARD DR Company: SERVICE AMERICA
Cit MISSISSAUGA State:ON Address: 2755 NW 63RDICT
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Zip Code: L4X 2W2 Fax: City: FT LAUDERDALE 1; iState:FL
Phone No.772-229-3124 Zip Code: 33309 Fax: 954-977-3591'
E-Mail: Phone No. 954-979-11001;
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: C'AC014619
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTR;UCTI.ON LIENIL`AW INFORMATION � ��' k . z
4,
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY:; j Not Applicable
Name: Name: II i
Address: Address:
City: State: City: i!: State:
Zip. Phone: Zip: Phone:;
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
city: City:
Zipt 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 cdvenants;;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,Wall 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 resuih in your paying twice for
improvements to your property. A Notice of Commencement must be recorded!a;nd posted on the jobsite
! before the first inspection. If you intend to obtain financing, consult with lender,or an attorney before
I
comryMncing work or recording our Notice of Commencement. L
I� s
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF
FLORIDA-STATE OF FLORID --p-'''
COUNTY OF COUNTY OF
The f9�{{ oing i was acknowledged before me The f� oing i stmt gym( t Alas�acknowledged before me
thisc�� day of rumor 20 /0 by this✓ day of 4 �, u r 20 /G by
r V i n sod � c�i�G� I j' ; i✓�6o n
(Na,e of p so acknowl 6ging) (Na a of pers acknowled
( ign r f to Public- tate of Florida) 'gnat a ofa �Publi State ofiFlorida )
Pers ally nown uce entifiCati�p Person O,R;Produced Identification
RY PUS, SheneKa Hard— Type of Identification Pr
Type f Idents i n Pr � Yp =e,® o ary eta �' �,' �� dyCommission No. n mesion#GG33870 = I' ofFlo'ida< c( �lr Commission No. ®►;Expires 9127/2020 f „; \e 33870�, Ca` 020
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATIONIf, SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE !'
COMPLETE
INITIALS ���