HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTEI
Date: Permit Number: iso 3 "C)O/s
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Building Permit Application
Planning and Development Services i
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553. Fax: (772)462-1578 Commercial I Residential X
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PERMIT APPLICATION FOR: Mechanical
P.RO:PQSED IM,PROVEM.ENT LOCATI„ N
Address: 10200 S OCEAN DR 205
Legal Description: ATLANTIS III BY THE SEA UNIT 205AND PRO-RATA SHARE IN COMMON ELEMENTS(OR 537-502)
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Property Tax ID#: 4511-518-0013-000-5 Lot No.
Site Plan Name: ! ' Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side!
DETAILED OE-SCR IPTION"OF°WORK ,; Y
tG- fi -
Charge oc-H � s�� i�F S�"-7 S' W
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77,
CONSTRUCTION INFORMATION;, '
Additionalwork to be nertormedd under tispermit—c ec a appy:
❑✓_HVAC Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
❑Electric ❑ Plumbing ❑Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: S . Ft. of First Floor:
3961
Cost of Construction:$ Utilities: _Sewer❑Si ptic ! Builtling Height:
.
OWNER%LESSEE•. CONTRACTOR:;; y.
Name Maria Moretti&Vincent Moretti Name: RICHARD LEVINSON
Address:18 Windsor RdCompany: SERVICE AMERICA
City: Toronto State:ON Address: 2755 NW 63RDICT
Zip Code: M9R 3G1 Fax: City: FT LAUDERDALEState:FL
Phone No. 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: CAC014619
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If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.:
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SUPPL'EMENTALs:GONSTRUCTfON LI�ENYILAIN INF l' ii l
ORIVIATION;
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DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address: I
City: Stater City: I 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 m'ay restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions,
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wich may apply.
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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.
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Signature of Owner Contractor as Agent for Owner Signature of-Gon r ctr/License Holder
STATE OF FLORI@STATE OF FLO I� 7
COUNTY OF ou—"�' COUNTY OF
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The foor�oing irr r me was acknowledged before me The forgoing' r e t was'acknow,ledged before me
this day of 20 Lt by this day of Yl.!'c�rL 20 �� by
•(Nam of person edging) (Name pers ac k Towle ;ing)
(Sign re of N ary blit-St to of Florida) (S' ture f Nota OR Publi -State of,Florida)
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ers ally Kn n a ion Pers Proddced IdPnrlfira
Type of ] ]cation Pr d Pis sheneka Hardy Type of Identificatio ro
A& 0 NotaryPublic-state oForma A,'(
= Notary P blit-state of Florida
Commission No. Q�p ssion#GG 33870 Commission No.
o a � �CommEi0
Expires 9/27/2020
Exp fres 9/27!2^20
oFF�
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATIONI;., SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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