HomeMy WebLinkAboutBUILDING PERMIT APPLICATION+i r
APPLICABLE INFO MUST BE COMPLETED FORAP.PLICATION TO BE ACCEPTED
Date: 3I�"1 �`� Permit Number:
RECEIVED MAR 2 9 2016
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial Residential X
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION
Address: 10701 S OCEAN DR JENSEN BEACH, FL LOT 740 ;
Legal Description: VENTURE OUT -SECTION C- LOT 141 (OR 3833-2688)
Property Tax ID #: 4511-805-0141-000-2
Site Plan Name:
Project Name:
Setbacks Front 10 Back: 5
DETAILED DESCRIPTION"OF,WORK:`.
Right Side: 6" Left Side: 8
BUILDING NEW CBS TWO STOR HOME
CONSTRUCTION LNFORMATIOW ',-
'Additional itiona work to e e orme d un er t is permit— c
�HVAC 13 Gas Tank ❑Gas Piping
Electric IZI Plumbing Sprinklers
Total Sq. Ft of Construction: G % z lj
Cost of Construction: $ 2(9, c7es? Uti
OWNER/LESSEE: "
Name Robert J Floyd Orilla M Floyd
Address: 261 Ponce de Leon ST
City: ROYAL PALM BEACH State: FL
Zip Code: 33411 Fax:
Phone No. 772-229-0012
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Lot No.
Block No.
heCK all that apply:
El_ Shutters Q Windows/Doors
EGenerator W1 Roof
Sc.- Ft. of First Floor: 5�.Y�D_
lities: Lr jSewer Septic Building Height:
CONTRACTOR:
Name: MACK MATOS
Company: MEL-RY CONSTRUCTION
Address: 10967 S OCEAN DRIVE
City: JENSEN BEACH State: FL
Zip Code: 34957 Fax: 772-229-9440
Phone No. 772 229L9439
E-Mail: MACK@MEL-RY.COM
State or County License: 23630
If 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
NaAe: HARVEY KOEHNEN PE 32831
Name:
Add Tress: 7205 ELYSE CIRCLE
Address:
City:IIPSL State: FL
City: State:
Zip: 2831 Phone: 772-466-5509
tl
Zip: Phone:
FEE S�MPLE TITLE HOLDER: Not Applicable
BONDING COMPANY: Not Applicable
_
Namei
Name:
Address:
Address:
City: �I
City:
Zip: I Phone:
Zip: Phone:
I certify'p',hat no work or installation has commenced prior to the issuance of a permit.
St. Lucie ,.ounty makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is i" 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 consldtlration 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 folio IIng building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory 7
ructures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARIYIN� 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 th first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencing work or recording vour Notice of Commencement.
Signature d Owner/ Lessee/Agent `
STATE OF �)ORIDA
COUNTY OF �� �eti�
The forgoing instrument wq§ acknowledged before me
this day ,! f/91er( 20f (, by
01,31(04/yl_ F12�1
;me of person acknowledging )
of
Commission
Public- State of
Revised 07/15/2014
STATE OF FLORIpA
COUNTY OF
The forgoing instrument was acknowledged before me
thisa� day of , 20 )�_ by
rngcl�. m�.�d5
(Name of person acknowledging)
(Signature of Notary
n I c tl Personally Known _
f Florida Type of Identification
i My Commission EE 224190
Expires 10/121200-c0eall Commission No.
State of Florida )
EFNNP S ENo Florida
roduced INfe0ificr�6
. _ MY
mission a� N
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