HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR Al
Date: 5 a 3
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Building
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
ICATION TO BE ACCEPTED
rNMWmit Number:By
StLuftcalw* RECEIVED
SO' MAY 2 3 2018
irmit Applicati n
ST. Lucie County, Permitting
Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
I PROPOSED IMPROVEMENT LOCATION: I
Address: 10725 S Ocean Dr #369 Jensen Beach FL
Legal Description: Holiday Out
Property Tax ID #: 4511-502-0185-000-2
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Lot No.32
Block No. R
DETAILED DESCRIPTION OF WORK: I
Repair Deck From Hurricane
CONSTRUCTION INFORMATION;'
Additional work to be bertormed uncler this permit— check all =apply:
❑HVAC Gas Tank ❑Gas Piping _ Shutters ❑ Windows/Doors
❑ Electric ❑ Plumbing ❑Sprinklers ❑ Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ $1500,00
Sq. Ft. of First Floor: _
Utilities: Sewer ❑ Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Paul RSalemme
Name:
10725 S Ocean Dr #369
Address: I
Company:
City: Jensen Beach ? State: FL
Address:
Zip Code: 34957 Fax: ?
City: State:
Phone No.617-480-4192
Zip Code: Fax:
E-Mail:salemme15@verizon.net
Phone No.
Fill in fee simple Title Holder on next page ( if different
E-Mail:
from the Owner listed above) I r
I
State or County License:
If value of construction is $2500 orlmore, a RECORDED Notice of Commencement is regwrea.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: I
INEER: _ Not Applicab
Name: MCR Professional Fnorinr+nring
Address: 3770 NW Royal Oak Drive
City: Jensen Beach State:
Zip: 34957 Phone 772-323-4865
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone:_
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
Not Applicable I BONDING COMPANY: _Not Applicable
Name:_
Address:
City:_
Zip:
Pho
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
commencing work or recording vour Notice oflCommencement.
sg I
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA ( �
STATE OF FLORIDA
COUNTY OF '_ I 1�, L' Q_
COUNTY OF
The oing instrument was acknowledged before I e
The forgoing instrument was acknowledged before me
this day of 201V by
this day of 20_ by
1�6 (L' 'Sck ISI(
Name of perso making statement I
Name of person making statement
Personally Known I/ OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
gh" &'g4l r— .11 -
Produced
(Signature of Notary Public- State of �i St'ete of Florida-
otafy �ub�lic Notary Public- State of Florida )
ma�yy//(( =b •= Commlealon N
`4
OG 194834
Commission No. �.,,� �.•` IMy Commleel
6 �gio No. (Seal)
fits ` March 11
2022
REVIEWS
FRONT
ZONING
S I PERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
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REVIEW
REVIEW
DATE
RECEIVED
j
DATE
COMPLETED
Rev. 8/2/17