HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE, INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED n
Date: SCANNED Permit Number:lln_
"M St. Lucie County
Building Permit Application
Planning and Development Services RECEIVED
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982 JUN 12 1018
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential Permitti,,, _- ,
PERMIT APPLICATION FOR: To. Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT,LOCATION€
Address: 5061 North AIA , Fort Pierce, FI. 34949
Legal Description: Bryn Mawr Ocean Towers-AOondominimnwmpnaing apart of N 550M on sections 14 and 15 tomahipM hinge 10 all MPD and shows in declaration of condominium pr447d10
Property Tax ID #: Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Concrete repair
CONSTRUCTION INFORMATION:
HVAC II Gas Tank
Electric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $
Piping
❑_Shutters
❑Windows/Doors
nklers
11 Generator
Roof
=
Roof pitch
S Ft. of First Floor: _
Utilities: Sewer 0 Septic
Building.Height:
OWNER/LESSEE:
CONTRACTOR:
Name Bryn Mawr Ocean Towers Condominium Assoc. Inc.
Name: Patricia Salazar
Address: 5061 North AIA
Company: Daniello, Salazar & Sons, Inc.
City: Fort Pierce State:Fl_
Zip Code: 34949 Fax:772-569-4300
Phone No.772-569-9853
Address: 2708 N. Australian Ave. Ste 9
City: WPI3 State:Fl.
Zip Code: 33407 Fax: 561-833-3573
Phone No. 561-835-4788
E-Mail:juliet@ellioftmenill.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: info@concreterepairing.net
State or County License: CGC 1524218
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: ML Engineering, Inc.
MORTGAGE COMPANY: _ Not Applicable
Name:
Address: _
City: `A'PB State:
Zip: Phone:
AddresS: 2030 37m Ave.
City: Fort Pie= State: FI.
Zip: 32960 Phone 772-569-1257
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address
BONDING COMPANY: _Not Applicable
Name:
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 vour Notice of Commencement.
as Agent for Owner Signature of Contractor7LTC9ff9UTr65rder
STATE OF FLOG `
COUNTY O� �_ L VL �t
The forgolk instrument was acknowledged before me
this , day of k V ssi_s:2 .20L by
1�il C -p-c- VL_
Name of person making statement
Personally Known K OR Produced Identification
Type of Identification
'6 & dIZAL=J;�-)
(Signature of Notary Public -State of Flonda I
Commission No.
REVIEWS
Rev.
RITASeWO
COMMISSION # GG 114413
EXPIRES: June 13,2021
STATE OF FLORIDA [
COUNTY OF�:!��
The for oinstrument was acknowledged before me
thisj,;,�:dayof,20-L?by
Name of person making statement
Personally Known OR Produced Identification
Type of Identification
(Signature of Notary Public -State of Florida
Commission No.
COUNNT TER TER I RENING VIEW W I SUPERVISOR REVIEW I PLANS
REVIEW
V
MY COMMISSION # GG 114413
EXPIRES: June 13.2021
REVIEW I REVIEW I REVIEW