HomeMy WebLinkAboutBuilding Permit Application-NEEDS UPDATINGI
PERMIT APPLICATION FoR: concrete
1-11y1 West Palm Beach State: FL
ccc-1518181State or County License:
Zip Code:33407
Phone No.561{35-4788
E-Mail:
Fax:561€33-3573
Daniello &
Australian Ave, Suite 9
Flll in fee simple Title Holder on next page ( lf different
from the Owner listed above)
772-229-9690
zip 6s6g.34957
City:Jensen Beach
772-229-7799
State:
The Princess Condo
9650 S. Ocean Drive
Phone
E-Mai
Ct)L, T"{T Y
(L
ALLAPPLICABTE INFO MUST BE COMPTETED FOR APPTICATION TO BE ACCEPTED
06/28/16
Permit Number:
Date:
Building Permit APPlication
Plonning ond Development Services
Buitding and Code Regulotion Division
2300 irginio Avenue, Fort Pierce FL 34982
;;;;irtt't 1G2-L553 Fax: (v72j 462 \578 Comrnercial
-
Residential-
9650 Q Ocean Drive;Jensen Beach,FL 34957 Unit #703
Address:
Legal DescriPtion:The Princess Of Hutchinson lsland
4502-61 0-0000-0006 Lot
Property Tax lD #:
Block No.
Site Plan Name:
Project Name:The Princess Condo
Setbacks Front-Back:
--
Right Side: Left Side:
Concrete RePairs
HVAC Gas Tank Piping Shutters
Generator
Windows/Doors
RoofEtectric I Rhmuing Sprinklers
Total sq. Ftof construction: -of
Cost of Construction: S Utilities:Sewer Septic Building Height:
lf value of construciion is or more, a RECORDED Notice of Commencement is required.
INFORMATION:CONSTRUgNON
Address:
Nr.r
t_ltr
SUPPLEMENTAL CONSTRUCTION LIEN I.AW INFORMATION:
DEST6NER/ENG|NEER:
Name: C$M - Engine€.ing. LLC
_ NotApplioble
Address : 1235 $.E, lndian St. Suite 103
City:State: Fl.
Zip:vw7 772-22s1,6l0l
MORTGAGE COMPANY: _ Not Applicable
Name:
Zip: _ Phone:
FEE SIMP1E TffLE HOTDER: _ Not Applicable
Name:
AIJ-^-..huut E)J.
Clty:
Zip: _ Phone:
Clty:
Zlp: _ Phone:
OWNER/ CONTRACfOR AFFIDVIT! Application is hereby made to obtain a permit to do the work and lnstallation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permh.
St. Lucie Counw makes no reoresentation that is grantinc a permit will authorize the Dermit holder to build the subiect strusture
which conflicts wlth anv aoolicable Homeownerslssoclalloh rules, bvlaws or and covenants that mav restrict or orirhlbit such
structure. Please consult with your Homeowners fusociation and ieview your deed for any restrictiois which may apply.
ln conslderation of the granting of thls requested permit, I do hereby atree that I will, in all respects, perform the work
in accordance wlth the approved plans, the Florlda Building Codes and St. Lucie @unty Amendments.
The following building permit applicatlons are exemfi from undergoing a full ooncurrency review: room additions,
accessory structures, swlmming pools, fences, walls, signs, screen nooms and accessory uses to another non-residential use
and subscribed before me of X rtrysical Presence or
-
Onllne Notarlzation
-<- I
--} o}-n L=en.d' a t-n , .
Name of person maklng statement.
TIMOTHY O. ERICIGOT{
MY COMillSSlOtl, GG aX55,
EXPIRES:
Bondod
4a"r;fu-,f
!
(Signature Notary
OF
Sworn tothtL (or
day of
of Contra.tor - or - Owner Eullder as applicable
z@by
Commission No.
COUNTY OF
Personally Known -X- OR Produced tdentification
Type of ldentificatlon Produced-
REV]EWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETAIION
REVIEW
SEA ruRru
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Address:
CiW:
BONDING COMPANY: _Not Applicable
Name:
WARI{ING TO OWNER: Your fallure to Rccod a Nodce of Commencement may rcsuh ln
be recorded
twlce for
Notice of Commencement must of
on before the rf intend