HomeMy WebLinkAboutBUILDING PERMIT ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:_ Permit Number:
i
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Viiginia Avenue, Fort Pierce F134982
Phone: ;772)462-1553 Fax: (772)462-1578 Commercial Residential X
ERMI'-APPLICATION FOR: To Select from dropbox, click arrow at the end of line
_, Ea..: ,.. „s... .i.:'.;:5„ ..,,,,,.. .a s,....._, .a✓?�z.. .�..,.�._..,s-.... ._ .r'C N/ z�� A � v'p ��'Address: 8600 S OCEAN DR UNIT LPH2 JENSEN BEACH, FL 34957
Legal De!;cription: REGENCY ISLAND DUNES TWO UNIT LPH-2(OR 1106-269: 1108-2061:2979-1439: 3012-1251)
Property Tax ID#: 3534-502-0062-000-2 Lot No. v
Site Plan Vame: TERRY FULK Block No.
Project N ame: FULK RESIDENCE
Setback!, Front Back: Right Side: Left Side:
ti 9 C
CHANGE OUT AC SYSTEM 3 TON/ 16 SEER/8KW
Mai3 - y'^� ;, r Epp e�
�ition 3 wor to epertormed under this permit—check all apply:
Ir IHb 4C (l I Gas Tank Gas Piping _Shutters a Windows/Doors
11 Elelctric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 6400 Utilities:Sewer E Septic Building Height: _
NameTE 3RANCE FULK Name: STEVIE SANDERS
Address:.B600 S OCEAN DR LPH2 Company: STEPHEN K DENNY
Caty: JErdSEN BEACH State:FL Address: 406 COMMMERCE WAY
Zip Codc: 34957 Fax: City: JUPITER State:FL
Phone Nf),317-460-6556 Zip Code: 33458 Fax:
E-Mail: Phone No. 561-743-9554
Fill in fees simple Title Holder on next page(if different E-Mail: LSLATER@STEPHENKDENNY.COM
from the Owner listed above) State or County License: CAC1813800
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: Not Applicable
Name:, Name:MORTGAGE COMPANY: Not Applicable
_
Address: Address:
City:_ State: City: State: _
Zip: _ Phone Zip: Phone: /
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: VNot Applicable
Name: Name: _
Addre!;s: Address:
City:_. City: _
Zip: — Phone: Zip: Phone: _
OWNER,f CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 it 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
it accord;:nce with the approved plans,the Florida Building Codes and St. Lucie County Amendments.
The follo%cing 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
WARNIIIIG 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 tie first inspection.#you intend to obtain financing, cons t with lender r an attorney before
commeri work or rec in our Notice of Commencement
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Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORID
COUNTY OF P �'Y 1 ,t e, b"� COUNTY OF
The forging instrument was acknowledged before me The forg°Ing instrument was acknowledged before me
this�.`�day of w C/i ,20I5 by this°day of `l i-Cj,- 201S' by
Name of perso_ n rpaking statement Name of persoon�aking statement
Persomilly Known l—' OR Produced Identification Personally Known OR Produced Identification _
Type of Identification Type of Identification - �'--!"�•.
Produu: �
DO ��i♦ ti� e,�NIDOW�����r
(Signature of Notary Public-Sty of)� '�{)2 ?Q?,N•• � (Signature of Notary Public-State o orid y 20• ;�
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Commission No. ; (Spal).,, , * Co Q9
mmission No. _yr ' (SeaU
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COUNTER 1%%i��VIEW REVIEW REVIEW REVIEW lti IIIIIA
DATE
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