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All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 2-8-2021
Permit Number:
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<� 4 Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial *** Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: �� �r�.�!* •�v ��
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Address::J7 UU Nortn Hllgnway A7A Fort Pierce, FI, 34949
Property Tax ID 0: 1425-606-0000-000-8 Lot No.
Site Plan Name: Sands On The Ocean Block No,
Project Name: Sands On The :Ocean
the existing call box with a new call box.
(High voltage permit by others)
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank i ' _ Gas Piping _ Shutters ! <__-_ Windows/Doors _ Pond
Electric _ Plumbing _ Sprinklers — Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor: _
Cost of Construction: $ 28, 000 Utilities: -Sewer —Septic
Building Height:
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Name Sands on the Ocean Section 1 CO
Name: Russel Lumsden
Address: 310.0 North Highway Al
Company: Remote Access Sales 2
City: Fort Pierce State:_
Address:446 NW Lake Whitney PI
Zip Code: 34949 - Fax:
city: Port St Lucie State: FI
Phone No. (772) 206-9601
Zip Code: 34986 Fax:
E-Mail:_ sands310ORgmall".com
Phone No 5612027493
Fill in fee simple Title Holder on next page ( if different
E-Mail Russel(a)-ras2fl xom
from the Owner listed above)
State or County License Co # 29798
If value of construction Is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC Is $7,500 or more, a RECORDED Notice of Commencement Is required,
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DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City: State:
City:
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 Couh makes no represe%trtion.that Is granting a permit %III agutporize th��ermit holds to build the subjectstructure
ucture
t it
which Is In conlict with aagpplica le Rome O= As-sociation ro, awsir:covenantse may prohibit such
I eWrIct.6r
structure. Please consult t your HorneOwners Association ewyour ee.ranyres ons,wh may ably.
In conslderation.of the grantingof this.requested, permit, I do hereby agree that I will, In all respects.. perform thework
In accordance with the approved plans, the Florida building Codes and St. Lucie County Amendments.
The following building permit applications are exempt,from undergoinga full concurrency review: room additions,
accessor So
ystructures, swimming pools, fence' walls, signs, screen rooms and accessary uses to another nonttesidentlal,use
WARNING TO OWNER: Your failure to Record.a Notice of Commencement -may result In ayingtwice for
Improvements, - A Notice Commencement be rift the St.
to your property. of must recorded public records of
Lucie County 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- your Notice of Commencement.
Signature of Owner/lessee/Contractor as Agent for Owner
Signature of Contractor/Ucense'H61der
STATE OF FLORID
STATE OF FLORIDA
COUNTY OF , Wr�
COUNTY OF3 �,o
Sworn to,(or. affirmed) and.subscribed before me of,
Sworn to (or affirmed) and subscribed before me of
Physical Ares or Online Notarization
this ��day of n1ly 2020,by
Physical Pre sSice pr Online Notarization
thIsj6t-day of. 2020 by
a kq S /W a 0/s e4-,
aik.:ss-4 Lu,,. Iq
-
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known "**16 OR Produced Identification
Type of Identification
Type of Identification
Producod.
Produce 1
(Signs re of Notary Publi of "6are Bean
(Signit0i of Notary Public-. MIN mane El �n
LL NOTAR41UBLIC
Commission No. FLORIDA
R
AT] Y PUBLIC
Commission No 'A §T fiff FLORIDA
=GG195204
Comm# GG 1 �5204
Exp 1res,
42U/2022
REVIEWS
FRONT
ZONING,
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
IV.