HomeMy WebLinkAboutBuilding Permit Application 5� J7
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: U0
RECEIVED
i6d
Building Permit-Application - JUN 0g,2o1B
Planning and Development Services Permitting De
Building and Code Regulation Division St. Lucie Counrtgent
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: Mechanical
PROPOSED IMPROVEMENT LOCATION:
Address: 9225 Avenel LN
Legal Description: PINES AT THE RESERVE THAT PART OF LOT 20 MPD IN OR 931-1798
Property Tax ID#. 3322-502-0027-000-4 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:,'
CONSTRUCTION INFORMATION: a
Additional work toe performed under tiJspermit—check all 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:
Cost of Construction:$ 6737 Utilities:0Sewer❑Septic Building Height:
OWNER/LESSEE:. CONTRACTOR:
Name CLARK JAMES&MARION Name: RICHARD LEVINSON
Address:9225 Avenel LN Company: SERVICE AMERICA
City: Port St Lucie State:FL Address: 2755 NW 63RD CT
Zip Code: 34986 Fax: City: FT LAUDERDALE State:FL
Phone No.973-985-0268 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.
S..UPPLEMENTALCONSTRUCTION LIEN LAW IN�FO'RMATION
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 Signature of Owner essee/Contractor as Agent for Owner Signature of Contactor/License Holder
STATE OF FLORIDA STATE OF FLO ID
COUNTY OF Nim and COUNTY OF =Vffird
The forgoing instrument was acknowledged before me The forgoing instru ent was acknowledged before me
this J day of �Unl? 20 )�by this � day of -1 J 20 J_�( by
Tl►C�)Qrj LeVin50n X'Acirj LVi nson
(Name of person acknowledging) (Name of person acknowledging)
ILI
(Signature of Notary Public-State of Florida) (Signature o otary Public-State of Florida)
PersonallyKnown .•P,rod _� PersonallyKnown_�0 Prad , Pd icPntification
� y �������� S--
Type of Identification Pr.' 1 Type of Identification Prod �rpr�q� ,n ,,ersrgnS
Commission No. — EXPIF tanuary 21,2020 Commission No. F -I ��p My COt� ff ON#FF952984
�4o��sea-0 5.7 rw,iaaNaarvSVy"cum „�.;,•• 1EXP1 E6 January 21,2020
(407)398-053 r1u.�12w;�a�.Sr+Srcwn i
Revised 07/15/2014
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