HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: I gas---
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• RECEIVED ---
Building Permit Application I
Planning and Development Services MAY 2 1 L I l�
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982 --- g 1
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 8650 S OCEAN DR 1006
Legal Description. REGENCY ISLAND DUNES BUILDING 1 UNIT 1006 (OR 1157-1192)
Property Tax ID#: 3534-501-0054-000-0 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Ukc,c-1 AC C hc1.-i.e O(-t t 5 tb/-)
CONSTRUCTION INFORMATION:
Additional work toe e orme under this permit—check a appy:
❑✓_HVAC 11 Gas Tank E]Gas Piping _Shutters ❑Windows/Doors
aElectric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 6036 Utilities: Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Rathburn Philip&Susan Name: RICHARD LEVINSON
Address:8650 S Ocean Dr#1006 Company: SERVICE AMERICA
City: Jensen Beach State:FL Address: 2755 NW 63RD CT
Zip Code: 34957 Fax: City: FT LAUDERDALE State:FL
Phone No.772-229-7997 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 thepermit 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 recording our Notice of Commencement.
i
Signatureo Contractor as Agent for Owner Signature of Contra icense Holder
STATE OF FLO%�DA STATE OF FLORID
COUNTY OFt") ,Y40t_a COUNTY OF ')(CA) C1
The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20 f-,'?by this A day of 20 by
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chn rA u i n.�or1 9 hard LP II n s c n
(Name of erson acknowledging) (Na f person acknowledging)
(Sighature of N t ry Public-State of Florida) (Signature tary Public-State of Florida )
Personally Known V kient#+c Personally Known OR Produced Identification
Type of Identific iQ{UPi�4uce� O NETTLES Type of Identific 7741,&
MMISS/IiONll�a FF952984 PATTIE JO/IC�N�pE(r�TLES
Commission No. RES J2r�@§4 21.2020 Commission No. MY MMISSIO'ISf" PF
'-?•!!�• !,•o.::� EXP 952984
EXPIRES January 21_,2020
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Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS