HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPUCABLJE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: S SCANNED Permit Number:/ V 0S
St. Lucie County
RECEiVEC
Building Permit Application Planning and Development Services MAY 2 1 20 5
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Other
PROPOSED IMPROVEMENT LOCATION:
Address: 9960 S. OCEAN DRIVE, JENSEN BEACH, FL 34957
Legal Description: THE MIRAMAR II CONDOMINIUM
Property Tax ID #: 4502-702-0000-000-0
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
CONCRETE RESTORATION AS PER ENGINEERING SPECIFICATIONS. QUANITIES LISTED IN ENGINEER SPECS
CONSTRUCTION INFORMATION
ltiona wor to e e rme under this permit— check all N apply:
❑HVAC Gas Tank
11 Electric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 100,000.00
Lot No.
Block No.
Piping _Shutters ❑Windows/Doors
nklers ❑ Generator Roof
_ S Ft. of First Floor:
Utilities:Sewer ❑Septic Building Height: _
:OWNER/LESSEE:
CONTRACTOR:
NameTHE MIRAMAR II CONDO ASSOCIATION
Name: MICHAEL SCELLATO
Address:9960 S. OCEAN DRIVE
Company: REFLECTION RESTORATION LLC
City: JENSEN BEACH State :FL
Zip Code: 34957 Fax:
Phone No.772-229-9192
Address: 2224 MANELE PLACE
City: PALM CITY State: FL
Zip Code: 34990 Fax. 772-220-1804
Phone No.772-215-8627
E-Mail: MIRAMAR2CONDO@GMAIL.COM
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: MS34986 ,AOL.COM
State or County License: CGC 1512222
If value of construction is $2500 or more, a RECORDED Notice of Commencement Is required.
SUPPLEMENTAL CONSTRUCTIONLIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: CSM ENGINEERING
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: 2081 SE OCEAN BLVD, SUITE 1 A
Address:
City: STUART State: FL
Zip: 34997 Phone: 772-220-4601
City: State:
Zip: Phone:
FEE SIMPLE TITLEHOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
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 contlict 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
_ Signature of Owner/
STATE OF FLORID STATE OF FLORIDA
COUNTY OF /Y� COUNTY OF�/XCTI A/
The for oing instru ent was acknowledged before me The forgoing instrument was acknowledged before me
this ff day of 20 /51by I this l/ day of � 20 /5' by
VEPINMI1 Q05 2 111W,i44EA MICHAEL SCELLATO
(Name of person acknowledging) (Name of person acknowledging)
Personally Known OR Produced Identification
Type of Identification Produced
IWRAt0F (Seal)
MY COMMISSION II FF 014554
(Signature of Notary Pu Ic- State of Florida )
Personally Known X-�OR Produced Identification
Type of Identification Produced
Commission No. (Seal)
EXPREn5P
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