HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Dater yI131\C Permit Number: \�O`F Oa35
sy " RECEMD APR 18 2016 SCANNED
pp St. Luce
Building Permit A lication �,
Planning and Development Services County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 349B2
Phone:(772)462-1553 Fax:(772)462-1578 Commercial x Residential
PERMIT APPLICATION FOR: Other ,II
PROPOSED IMPROVEMENT LOCATION:
Address:
Legal Description: '1 1t3 ocean Dr. Jensen Beach fl. 34957
0100
Site Plan Name:
Project Name: _
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Lot No.
Block No.
Concrete restoration Inspected by special inspector Breitenbach Engeneering, PE (772)834-4743
CONSTRUCTION INFORMATION: li
❑HVAC Gas Tank
Electric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ $4800.00
Piping L_IShutters
nklers 11 Generator
S Ft. of First Floor: _
Utilities Sewer oSeptic
OWNERAESSEE:Ocean Towers Condo. Association
First Service Residential C/O Ocean Towers Co.,,.,..
Address: 9400 S. Ocean Dr.
City: Jensen Beach State:fl_
Zip Code: 34957 Fax:
Phone No.(772)229-2229
E-Mail: stephanie.m.vera@fsresidenbal.com
Fill in fee simple Title Holder on Inext ppage (if different
from the Owner listed above) ii
S'�\g►c osk t (ate �Q o
If value of construction is $2500 or more, a RECORDED Notice o
OWindows/Doors
j
1j Roof
Building Height:
CONTRACTOR: special Forceses Restoration and construction
Name: Michael A. Roberts
Company: Special Forceses Restoration and construction
Address: 1235 NE Dixie Hwy
City: Jensen Beach State: FI
Zip Code: 34957 Fax:
Phone No. (772)334-2990
E-Mail: Judi@specialforcesus.com
State or County License: CGCO59083
Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: BREITENBACHENGENEERING,PA
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: 4853 SE Pilot way
Address:
City: Stuart State: rI
Zip: 34997 Phone: m2i834-4743
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ 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
Quip a" C G6(Juk � ����7�—� s
_ Signature of Owner/ Lessee/Agent Signatu of Co ractor/License Holder
STATE OF FLORIDA STATE OF FLORIq�
COUNTY OF ,Sf �t�/ COUNTY OF /7" /ZT//V
The fo oing instru ent wa acknowledged fore me
this day ofapfic[ . 20 by
(Name of person acknowledging)
A e, ��rc—'— S
(Signature of Notary Public -State of Florida )
of
Commission No.
Revised 07/15/2014
The for QIng Instrument was acknowledged before me
thisa%� day of 20 (,0 by
(Name of person acknowledging)
Notary
Personally Known OR Produced Identification
Type of Identification Produced
Commissim FF244521
Expires October a 2019
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