HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED `FOR APPLICATION TO BE ACCEPTEu r
Date: 1.11• IiF SCANNED Permit Number: 1 ' O
BY RECEIVEI)
St. Lucie County JAN i i
2016
-- OWN - w*
Building Permit Application
Planning and Development Services PERMITTING
Building and Code Regulation Division St. Lucie County, FL
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Alteration 1 is .I;a,. ( `L\\:,..p1
PROPOSED IMPROVEMENT LOCATION:
Address: 10600 South Ocean Drive. Jensen Beach, FL 34957
Legal Description: OCEANA SOUTH CONDOMINIUM 11 UNDIV SHARE IN COMMON ELEMENTS (OR 3638-1763)
Property Tax ID k: 4511-517-9984-000-5
Site Plan Name: 62726 Oceana South II
Project Name: 62726 Oceana South II
Setbacks Front Back:
Right Side: Left Side:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK 'I
• aY
Remove and replace existing Verizon Wireless Telecommunications cabinets.
CONSTRUCTION INFORMATION_
Ar{r-{iTinnnwnr Tn ono nrmn iin nr T is normiTT tkint nnn ,r f `
11HVAC I Gas Tank
11 Electric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 1800.00
L_jGas Piping
❑Sprinklers
Shutters ❑ Windows/Doors
Generator 11 Roof
S Ft. of First Floor:
Utilities:]Sewer Septic Building Height:
OWNER/LESSEE: •.
CONTRACTOR:
Name Verizon Wireless
Name: Michael Poirier
Address:777 Yamato Rd.
Company: J•Crompton Electric, Inc.
City: Boca Raton State: _
Zip Code: 33468 Fax:
Phone No.
Address: 1290 Old Congress Ave.
City: West Palm Beach State: FL
Zip Code: 33409 Fax: 5615859088
Phone No. 5615886559
E-Mail:
Fill In fee simple Title Holder on next page'( if different
from the Owner listed above)
E-Mail: DylanW@Jcromptonelectric.com
State or County License: CGC62911
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCfl`ON LIEN INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: Adrian nozen/Foreslte Group
MORTGAGE COMPANY: _ Not Applicable
Name:
Address; 101590 Highland Manor Drive. Suite 210
Address:
City: Tampa State: FL
Zip: 33610 Phone: 813-549-3250
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 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 of Commencement..
_ Signature of Owner/ Lessee/Agent
STATE OF FLORIDA
COUNTY OF Palm Beach
The r oing ins tLum nt w s a knowledged efore me
thi _ day of 1y= , 20 �by
Mark Morris VZ%4m
(Name of person acknowledging )
State
Personally Known x 01 ProckLcedl`
Type of Identification turdnYJ AN D WAqHBJ1EN
Commission # FF 123281
Commission No. FF 12p res M�4at2018
••P.,',u AOG Thv Tra Funl no&10a86]0r9
Revised 07/15/2014
STATE OF FLORIDA
COUNTY OF Pa. Beach
The forgoing instrument was acknowledged before me
this 25 day of December 20 _by
Michael Polder
(Name of person acknowledging)
Public- State of Florida )
Personally Known
Type of Identificat e�YLAN D. WASHBURN
:: ..: �mmissfrnrttf�1232
a Expires May 14, RQ1�8l,�-
Commission No. P re om W Tmycai lraau}m] 10
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIE
REVIEW
REVIEW
REVIEW
REVIEW
DATE
1101b�(O
/
COMPLETE
INITIALS
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