HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 02/04/2015 Permit Number:
ED
Building Permit Application SCANNED
Planning and Development Services St Luc" Cotintb
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line II
PROPOSED IMPROVEMENT LOCATION:
Address: 10000 South Ocean Drive, Jensen Beach, Florida
Legal Description: 23741 BEG AT INr S LI GOW LOT4 AND ELV RW U ST A1A TH RUN N 22 DEG 58 MIN 45 SEC W 68.50 Fr. TH N 67 DEG 01 MINIS SEC E 65FT, TH N 22 DEG
58 MIN 45 SEC W 17Fr, TH N 67DEG 01 MIN 15 SEC E 13Fr, TH S 22 DEG58 MIN 45 SEC E 117.99Fr TO S LI DOW LOT 4, TH S 89 DEG 38 MIN 13 SEC W ALG SD S U 84.50Fr TO FOB
Property Tax ID ti: 4502-314-0003-010-1 Lot No.4
Site Plan Name: Miramir Property Owners Association Block No.
Project Name: Water Treatment Plant
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Complete Demolition 4e; Iv\0,l
Q�\�Vcz"A- 1Q00 SgRi tCrnejA) o� �� ,5�1:ob,f�e e✓s
CONSTRUCTION INFORMATION: III
HVAC L_ Gas Tank UGas Piping
Electric ❑ Plumbing ❑Sprinklers
Total Sq. Ft of Construction: _
Cost of Construction: $ 2,450.00
Shutters ❑ Windows/Doors
Generator ❑ Roof
S Ft. of First Floor: 1,000
Utilities:Sewer❑Septic Building Height: 1story
OWNER/LESSEE:
CONTRACTOR:
Name Miramar POA Inc.
Name: Randle L. Beckford
Address: P.O. Box 413
Company: L.E.B. Demolition & Consulting Contractors, Inc.
City: Jensen Beach State:FL
Zip Code: 34957 Fax:
Phone No.772-229-9192
Address: 7 Harbour Isle Drive East 204
City: Fort Pierce State: FL
Zip Code: 34949 Fax: 772461-2225
Phone NO'. 772-461-4545
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: iwreckn@aol.com
State or County License: 26948
It value of construction is $Z500 or more, a RECORDED Notice of Commencement is required.
I SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: III
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
Name:
Address:
City:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name: _
Address:
City:
Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Count makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in coNict 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 your Notice of Commencement.
_151gnaturl? of Owner/ Lessee/Agent
STATE OF FLORIDA- , 1 , . - STATE OF COUNTY OF FLORIDA I��
COUNTY OF �'t� w��l .y+—
The f r oing instru t was acknowledged b fore me
this day of �tM .. 20 lby
Lo—nd-u—
person acknowle�
of Notary
L e�-�A
The for oing instrFent'wa_s acknowledged before me
tt this _ day of .t.Y✓vl,tun.t:1 .20 15—by
(Name of person
(Signature of Notary PublicyState of
Personally Known "� OR Produced Identification I Personally Known ✓ OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No.1 E2 31-0- (Seal)
MY COMMIssWna nc -
Revised07/15/2014 1-My ExPM:Au9=!4.2016
Commission No. GEZol3-ia (Seal)
HIISSA C. BLANOR
MY COMMISSIORt EE20
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