HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONALL APPLICABLE INF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: SCANNED Permit Number:
BY
AR-
_ St. Lucie County
Building Permit Application
Planning and Development Services
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
PROPOSED IMPROVEMENT LOCATION:
Address: 10725 S OCEAN DR 419
Legal Description: HOLIDAY OUT AT ST LUCIE -SEC B BLK Q LOT 28 AND EQUAL PRO-RATA INTEREST IN COMMON ELEMENTS (OR 3670-994)
Property Tax ID #: 4511-502-0145-000-0
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK: III
remove existing pedestal. install 150 amp meter combo service mounted on 2" strut stand
INFORMATION:
LJHVAC L_J Gas Tank
Electric 0 Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 1,400.00
Piping LJShutters ❑Windows/Doors
nklers Generator 0 Roof
S Ft. of First Floor:
Utilities Sewer Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Ronald D Osbom Marsha L Osbom
Name: John R Law
Address;1940 Bamby Ln
Company: Law's Electrical Service Inc
City: Milford, State:FL
Zip Code: 48381-2107 Fax:
Phone No. 1 248 444 7993
Address: 5158 NW Primm St
City: Pt St Lucie State: FL
Zip Code: 34883 Fax:
Phone No. 772 370 435
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: johnlaw5158@aol.com
State or County License: 25284
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION'LIEN LAW -INFORMATION:,
DESIGNER/ENGINEER:
Name:
_ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City:
Zip: Phone:
State:
City: State:_
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY: _Not Applicable
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 Counttyy 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 are 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, wails, 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
commencine work or recordine vour Notice of Cnmmpnrpmpnt
Signatu of Owner/Agent/Lessee
Holder
STATE OF FLOR DA STATE OF FLORID
COUNTY OF a c T COUNTY OF
The forgppmg instn�entwasacknowledged before me The forgping instrument was acknowledged ' before me
this"Z -day of -0 Lf t�'� � C' 20 14 by this2h ay of ��PC 2 vim. b-17', 20_14 by
`::s:— "�\ N ?, . \_" �) =,AN" t , Lg w
(Name of person acknowledging) - - - (Name of person. acknowledging)
22 (Signalure of Notary public- State of Florida )
Personally Known OR Produced Identification _
Type of Identificati n Produced
KATHRYN BUMBERA
Commission No.F_V_ 6 13146AARY PUBLIC
`STATE OF FLORIDA
Revised 07/15/2014 49W Expires
X
(Signatur— ebf Notary Public -State of Florida.)
Personally Known OR Produced Identification
Type of Identification Produced
THRYN-BUMSERA
Commission No.EF097% NOT51017pUBLIC
STATE OF FLORIDA
'..n:Caii3
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
COMPLETE
INITIALS