HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONT
ALL APPLICABLE INFO MUST 8E COMPLETED FOR APPLICATION TQBEACCEPTED
Date: SCANNED PermitNumhec
BY � �
~^�Lucie County ' RECEIVED
Building Permit Application UAN 0 6��
Kbnnk/pond8�vebpment��n��es -
Building and Code Regulation Division umem
2JO0Virginia Avenue, Fort Pierce FlJ4982 sitm"~`ecoun'Y
Phone: (77I)46Z'1563Fax: (772)4hZ'1578 Commercial Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
JPROP'Q��EEYIMPROVEMENT LOCATION:
Address: 1O051S.(]oeanDrive, Jensen Beach, FL34057
Legal Description: Windmill Village bythe sea Condominium No1
Property Tax |D#:
Site Plan Name: Community lighting improvements
Project Name: Windmill Village bthe Sea
Setbacks Front Back: _ Right Side:
Lot No.__�
Block No.
bt��` ''` _�� �"Q, ���� I-, ����������`��,'����"a� 1U|
� �
HV&C L-=1Gas Tank a!
Z`|ecthc El Plumbing | |Sp/
Total Sq. FtnfConstruction:
|Cost ufConstruction: $
IL- u°C�"m/ uvPv.
Piping Shutters
nkkero L`=]Generator
_ S Ft of First
Ud|ides�L==�Sewer L==]Sepdc
VVindovvs/D000
EiRoof = Roof pitch
Building Height:
AddrQsV "L"- _6� / -) !�L,;_7) 510 1 A!(Ld�
-company: American Lighting Maintenance, Inc.
Zip Code:2)4Q �� Fax:
City: Riviera Beach State:—
Phone No. 561-689-4854
E-MaiK
Fill in fee simple Title Holder on next page if different
from the Owner listed above)
E-Mail: George@americanlightingmaintenance.com
State or County License: Florida 5r4f 00(30-7
I Ifvalue ofconstruction is $25O0ormore, aRECORDED Notice ofCommencement |srequired.
SUPPLEMENTAL CONSTRUCTION=LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name,sokyx SreAen
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone — —
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: yCNot Applicable
Name:
Address:
Address:
City:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
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 your Notice of Commencement.
Signature of caner/ Lesse ontractor s Agent for Owner
Signature of ontractoMicense Holder
STATE OF FLORIDA
�
STATE OF FLORID
COUNTY OF ' l.(.G( �i
COUNTY OF _ _ Luzy e
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this _-fay of �iC1w1, 20AS by
thi5�y% _day of,) Ah� 20—[$by
�t0-or9z'_ �- !:7 J' n� P
¢�� 0- . J t, 11n� -�
Narge of so making saking ate meet
Name of person making statement
Personally Known � OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Pu IiCw o�f>�tfil§W 8GG 1 390
l
(Signature of ip
Notai u ac;St� 9� 110lm hnl/IiW
; •.,
No. 111Z�
/��s1 Eiplies Deceaber 12, 2021
� Commission
.�pf
Commission No.Cflrl BmdM T1.(50t71;li, Insusnre eaa1es70t
''',�„ww :•.g�.Tn.T•:1 if i.•�CE 00a167M�
REVIEWS
FRONT,
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE,
COMPLETED
Rev.8/2/17