HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �1
Date: 1 `�� 1 �1 Permit Number: 1101 d3 1 1
c RECEI\'_D JUL 182017
SCANNED
Building Permit Application St. BY
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 Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
RR`OPOSED IiVIPROVE IVIENT LOCATIONa
Address: 9490 S Ocean Dr.
Legal Description: Ocean Towers Condominium A -Unit 213 And Undiv Share In Common Elements (OR 3808-1469;3816-2421)
PropertyTax ID #: 3535-701-0012-000-1
Site Plan Name:
Project Name: Sam-10159955
Setbacks Front Back: Right Side: Left Side:
DETA(LED`DESCRIPTION'OF WORK
replace 6 windows and 1 door size for size
Lot No.
Block No.
CONSTRUCTION INFORMATION:;
_a
itiona I worKtODffrtormea unclerthispermit—c ec
❑HVAC Gas Tank ❑Gas Piping
all
apply:
_ Shutters
❑ Windows/Doors
❑ Electric ❑ Plumbing
❑Sprinklers
❑ Generator
❑
Roof
Total Sq. Ft of Construction:
S Ft. of First Floor:
Cost of Construction: $ 14735.00
Utilities.
Sewer ❑Septic
Building Height:
O W N ERf LESSEE.
CONTWA_CTOR:
Name Raul Sam
Name: Raquel Swanner
Address: 9490 S Ocean Dr.
Company: The Home Depot
City: Jensen Beach State: FL
Zip Code: 34957 Fax:
Phone No. 1-1?.— 20-t-- 25 (1
Address: 6500 NW 12TH Ave. Suite 110
City; Fort Lauderdale State: FL
Zip Code: 33309 Fax:
Phone No. (754) 224 - 2010
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail:
State or County License: CGC1514813
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPL`ENIENT'AL`CONSTRUCTIClN:LIEN LAW INFORMATION; u
q
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 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
befor inspection. If you intend to obtain financin�,c�nsuu� with lender or ap torney b ore
c meoxtnciniark or recordine vafir Notes of Commen emc ent. /
STATE Of-FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before
me this lb day of cSOU4 20 17 by
Signature
STATE OF FLORIDA
COUNTY OF llAV-V—
The forgoing instrument was acknowledged before me
this 13 day of 7aL3LV 20_17 by
P-11'a0e , 0EXt7a'%g`r $ZAG&XaL_ E LQatxC3f
(Name of person acknowledging) (Name of person acknowledging )
(Signature of Notary Public- State of Florida) (Signature of Notary Public- State of Florida )
Personally Known x OR Produced
Type of Identification Produce,.,
Commission No.
Revised 07/1512014
Ily Known x OR Produced Identification
Identification Prod uEf -
COMMISSION # GG 11 135
__.....,...._...I nn 4Com fission No.
TIMOTHY R. O'MALLEy
R1A ISSION # GG 117135
?XPIRES: Augue17.2021
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