HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: JULY 27, 2018 Permit Number: 0 0 1—(A S I
RECEIVED
Building Permit Application 2018
Planning and Development Services J U L 3
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 ST. Luc' County, Perini "
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Resi la
PERMIT APPLICATION FOR: Electrical
PROPOSED IMPROVEMENT LOCATION:
Address: 4250 N HIGHWAYAIA, NORTH HUTCHINSON ISLAND, FLORIDA 34949
Legal Description: OCEAN HARBOR SOUTH BLDG A UNIT 207 AND
UND INTEREST IN COMMON ELEMENTS (OR 660-284;3517-2737; 3921-2063)
Property Tax ID#: 1423-501-0015-000/8 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
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CONSTRUCTION INFORMATION:
Adclitional work toe nertormed under this permit—check all appy:
HVAC Gas Tank Gas Piping _Shutters ❑Windows/Doors
HElectric 11 Plumbing Sprinklers Generator Roof Roof pitch
Total Sq.Ft of Construction: 4pr S .Ft.of First Floor:
Cost of Construction:$��ZOO•co Utilities: Sewer 0 Septic Building Height:
OWN ER/LESSEE: CONTRACTOR:
Name James A Christo AND Joan I Christo Name: BILL Ul-ILL.L.1b
Address:80 Harvest Company: '
City: H State:MA_ Address
Zip Code: 91520Fax: City: PO State:FL
Phone No. Zip Code: 34983 Fax:
E-Mail:JI Phone No. 772-201-8
Fill in fee simple Title Holder on next page(if different E-Mail: BI
from the Owner listed. above) State or County License: ER 13014850
1f 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:
OWNER/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 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
commencin wo_Lk or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor a gent for Owner Signature of Contractor/License Holder
STATE OF COUNTY OF FLORIDA S. 44&e COUNTY OF STATE OF FLORIDA
S7- L(/16—
The f rgoing instru ent w acknowledged—before me The forgoi�ng�instrument was a knowledgleYefore me
this Q ay of (. 20 by this �fiflfay of ��u�,��20/% by
w/aAm C Lf�_�S
Name of per o making statement Name of perso making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(S' nature of Notaar P blic-State of Florida) (Signature of Nota P lic-State of Florida)
Commission No. T 33 Se I Commission No. T2153 (Seal)
�vtr Notary Public State of Florida �r�, Notary Public State of Florida
Klmle J Simone
hi y commission FF V31331 Kim SIM
my C ommisslon FF 96133
REVIEWS
M�EK# 2020 OR PLANS A iOI�PI 5M911f@9 LE GROVE
VIEW REVIEW IEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17