HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:_�A-a.\NA SCANNED Permit Number:
BY
_ St. Lucie County RECEIVED
Building Permit Application AUG 0 2 2018
Planning and Development Services
Building and Code Regulation Division ST. Lucie County, Permitting
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Other
,PROPOSED IMPROVEMENT LOCATION:
Address: 4200 N HIGHWAY AIA, FORT PIERCE, FL I
Legal Description: OCEAN HARBOR SOUTH BLDG * SOUTH BLDG)
PropertyTax]D �`1a3- S0)_d�6q-Ooa"�
Site Plan Name:
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
CONCRETE RESTORATION UNIT 1009
Right Side:
Left Side:
Lot No.
Block No. _
I -CONSTRUCTION INFORMATION: III
DHVAC LJGas Tank
0 Electric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ !f! WI Z r
Piping
Sprinklers
Shutters Q Windows/Doors
Generator 0 Roof = Roof pitch
Sq��Ft.I of First Floor: _
Utilities:LJSewer Septic
Building Height:
OWN ER/LESSEE:
CONTRACTOR:
Name OCEAN HARBOR SOUTH CONDO ASSN
Name: ROBERT STARK
Address:4250 N HIGHWAY AIA
Company: STRUCTURE -CON
City: FORT PIERCE State: FL
Zip Code: 34949 Fax:
Phone No. 772-569-9853
Address: P.O. BOX 2626
City: OKEECHOBEE State: FL
Zip Code: 3 61 V Fax:
Phone No. 772-215-8631
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: STRUCTURCON@,AOL.COM
State or County License: CGC 061033
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name: In Ic OW 0 (,4 yC✓
MORTGAGE COMPANY:
Name:
t Applicable
Address: .20 3 0 1 -71 r?'/ ii
Address:
City: o,9-40' State: i L
Zip: 3a P66 Phone oZ—SLY—/25
City:
Zip: Phone:
State:
FEE SIMPLE TITLEHOLDER: _,&Aot Applicable
Name:
BONDING COMPANY:
Name:
2CNot Applicable
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 reoTding your Notice of Commencement.
f k�&IZ2�
Signature of Owne / L asee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
T. Kkye -r
STATE OF FLO DA ,(
6oatfiL
COUNTY OF ,Ava,-,
COUNTY OF�� �q
The fqr ng instru ent was acknowledged before me
The for oing instrument as acknowledg efore me
this L day of L F 20/� by
this day of 201 by
e'he (��s
6io siyR
Name of persopmaking statement
Name a on making statement
Personally Known VV OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
M:EGH FLAIRSSK)N
p FF9072S4
*rj;WW
FY�2(Sig0�tsi
re of Notary Public- State of Florida)
(Signs a of Notary P of ,
°' !'.ILIE RRETT
��
Comion No. __°• �I
Commission No./ �� (Seal)
i MY _OL?MISSION #FF732752
EXPIRES September 28, 2078
REVIEWS
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
FRONT
ZONING
COUNTER
REVIEW
REVIEW
RE IEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
G
DATE
p�
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COMPLETED
0
Rev.8/2/17