HomeMy WebLinkAboutBUILDING PERMIT APPLICATION0
All APPIJCABIJ INFO TST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Q I Permit Number: QI
- SCANNED
Building Permit Application
Planning and Development Services LUCie County
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: To Select from dropbox, click here
Address: HUTCHINSON ISLAND CLUB 10410 S OCEAN DR JESEN BEACH FL 34957
Legal Description:
Property Tax ID #: 4511-514-0000-000-9
Site Plan Name: HUTCHINSON ISLAND CLUB
Project Name: HUTCHINSON ISLAND CLUB
Setbacks
Back: Right Side: Left Side:
INSTALL NEW A/C TO ELEVATOR MACHINE ROOM
`1 �n � SP � ►-� S�s-�
u
❑✓ HVAC IJ Gas Tank
11 Electric 0 Plumbing
Lot No.
Block No.
oas Piping ❑_ Shutters ❑Windows/Doors
Sprinklers Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: ScI�Ft.� of First Floor:
Cost of Construction: $ ad 94717 •ca • Utilities: Sewer OSeptic
Building Height:
.. .
Name HUCTHINSON ISLAND CLUB
Name:, 4
Company: a waib1hQ,i'"(rrOnw3 --MQ.
Address:10410 S OCEAN DR
JESEN BCH FL
City: State: _
Zip Code: 34957 Fax:
Phone No.
Address: 2369 W 78TH ST
City: HIALEAH State: FL
Zip Code: 33016 FaxsafM-140QC7
Phone No. 3058058166
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: PERMITTING a(��4USTENELETRIC.COM
State or County License: 7 Zc
II If value of construction is $2500 or more, a RECORDED Notice of Comme ement is required. II
V-6
� r ce����
.' ., `.I .:..
,.. : ._a.
h•-
P���',.
.. tom.:'`
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
BONDING COMPANY: _Not Applicable
Name:
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 CountyY 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
comiriensfng work or recording vour Notice of Commencement.
s
see/Contractor as Agent for Owner Signature of Contractor/License Ho r
STATE OF FLORIDA
COUNTY OF j
The forgoing instrument was acknowledged efore me
thiso�day of 20 / y
person acknowledging
Personally Known _
Type of Identification
Commission No.
Revised 07/15/2014
MY COMi�VMK)N a FF969259
EXPIRES Mach 08. 2020
STATE OF FLORIDA �JJ
COUNTY OF I(-/ � aai- 4-G�kQ
The forgoing instrumgnt/w-as acknowledged before me
this %L day of l 20 IT by
l�i�aa� 1
(Name of person acknowled ng )
(Signature of Notary Public —State of Florida )
Personally Known Lel'� OR Produced Identification
Type of Identification Produced
Commission No. ,:!.^..'°!!o'•.
�,,_ (NCIS M
:• i•i MYCOMMISSION
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS