HomeMy WebLinkAboutBuilding Permit Application 3 2/5-/Y7/
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 0/05' !�Date: Permit Number: ' Opo
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Building Permit Application REC671,6Q
Planning and Development ServicesNA
Building and Code Regulation Division 0 )a 1®
2300 Virginia Avenue,Fort Pierce FL 34982 . Pe
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Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residentials.6„,EDepa
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PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT.LOCATION:
Address: 3-705 S/ NT1 1 eccGpkGL (rie
Legal Description: The {e_6et`Ve van a-)Q Club sit 96 LO1 Z8
Property Tax ID It: 3t-4 26 - —70& — 004"0- 000-3 Lot No. Zg
Site Plan Name: Block No. '15
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Occi c-Mn e. Oc_t`f , -1-00,s ,y- weer 10 ia3
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all h apply:
HVAC _Gas Tank [ Gas Piping Shutters Li Windows/Doors
I IElectric Fl Plumbing Sprinklers _Generator _Roof Roof pitch
Total Sq. Ft of Construction: sol. Ft. of First Floor:
Cost of Construction:$ ,.- 1/L Utilities: I 'Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name i 0.--ni 1jGCC 13YUCe e, roma J le. Name: RICHARD LEVINSON
Addre��ss:7E5 LOhifie ...1-L1.4.5L2ne Company: SERVICE AMERICA
City:Toro cal U1C1 2 State:11 Address: 2755 NW 63RD CT
Zip Code:4C15Z— Fax: City: FT LAUDERDALE State: FL
Phone No.-7-7Z—040 -4,3001 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.
•
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
commencing work or ecording your Notice of Commencement.
Alma C ; s
Signature of Owner/Le.see 0 ontractor as Agent for Owner Signature of Contr-act,)1/_/' nse Holder
STATE OF FLORI • STATE OF FLORID' I
COUNTY OF O rue COUNTY OF IDc�C'I rij
The forgoing instrument ms acknowledged b fore me The forgoing instrument was acknowledged before me
this. day of Ain,'i , 20 I% by this day of A-Qr% 1 ,20 r( by
,
V7YO( I 1,---C-\111r) s(.- (C ri rj { v %►--r>c)Y)
(Name of person acknowledging) (Name of person acknowledging)
_it,a62.2sgeP.---Th . _: ' _,l/
(Signature of Notary Public-State of Florida) (Signature of Notary Public-State of Florida)
Personally Known ✓ OR Produced Identification Personally Known .- OR Produced Identification
Type of Identification Produced Type of Identification Produced R
FY Pei. Kimeko Allen o-P I �e� Kimeko Allen
Commission No. ..,'.. - a-I o`P c k-.f ICo.mmission No. ap�`a-7D--t s �(`@ �otaryPublic-StateofForida
at, otaryPublic-StaieoEFon a N, +d �. Commission#GG 75-/71
(0 'iti"" ac Commission#GG 75771 -15.•lF`er- Expires 2/22/202'
/` - Expires 2)22r20z.1
k-CFFI
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS