HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 515/15 Permt,Number:. ��
J 6,5
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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 xxxxx Residential F
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line � C, I Co
0,11095MIMPRCOVEIVIENTLOCATIQN
Address: 10,701 S Ocean Dr Ste,2
Legal Description: HOLIDAY OUT AT ST LUCIE-SEC B BLK U ALL(OR 270-1419)
Property Tax ID#: 4511-502-0213-000-8 Lot.No.
Site Plan Name:, Block No,
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED [}ESCRIPTION OF WORK:
remove existing meter and dist for reality-office. install 150 amp meter combo pack
CONSTRUCTIONINFORMATION
Additiona workto b e e orme under this permit-check.a appy.CIVAC GaTank
QWindows/Doors❑
Shutters
Electric El Plumbing 0:Sprinklers n Generator ❑Roof
Total Sq.Ft of Construction: S Ft.of First Floor:
Cost of Construction:_$ 1,500.00 Utilities: Sewer l leptic Building Height:
OWNER/LESSEE': " CONTRACTOR
Name Venture Three Inc Name: john.law.
Address:10701 S Ocean Dr Ste 2 Company: law's electrical service inc
City. Jensen.Beach State:FL Address: 5158 r w primm.st
Zip Code: 34957 Fax: City: PSI State:fl
Phone No.7721919 2368 Zip Code: 34983 Fax:
E-Mail: Phone No. 3704357
Fill in feesimple Title Holder on next page(if different E-Mail: johnlaw5158@aol.com
from the Owner listed above) State or County License. 25284
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
S i'PSV N } 05 'T L EJ U NFC F�iM.A t� l�
pESIGNERtENGf[dEER Not A pHcab{e
P MORTGAGE COMPANY: `Not-Applicable
Name Name:
Address: Address:
pity; State..
Crty., State
Zip;. Phone: gip= Phone, .
FEE SIMPLC TITLE HOLDER: _N.ot"Ap.plua.b{e BONDING COMPANY: �Nvt Apphcabl:e
_.
Name:. Name: _
Address: At3dress; _
cry: City:
Phone:
ZrP , Z Phone, . .
i cert(fy that no wocic:or installation has comrnenced:prior to f ie issuance•of a permit.
>& Lucie:Count�inal<es no r�tstesentation:thpt�sgranting: perrnifiiivIll authorize the.permrt{tolderto build thesubjeetiirueture ,
which s zn cod€!ut'. r th ati.Y applicable Florae f7wners.Assoc anon rules,bylaws orae tovenants;tFtatrnay restrict or prohibit sgch
stixlcture,Please:consultwitfa ydur.•.Hpme Qkvners Assodlation and:rewew our".deep#for an.+restrictions wFtieh may apply;
1n consrdei anon of the grarfhng r f thosieguestedpermit.,'I db hereby agree than will,in alt respect5,.:perform the work
in accordance Ft+tith tile.approvect:plans{fl�e F[otide; u�lding:.t des ancft.:.l time CotntyArrtiebdmerts.
Tlie follovurng buiidmg perCn►t applications are exempt frorri undergoing a ful(cpktirrency review:room addrttons,.
access4rystructcrres, ri xtm�ng:fsools fences;.walls,.signs;screen eooms:and accessory uses'te anottiet1ft0h4esidentWf use::
1NAEtNIfVG TO 4WNi •Yoyr fa�fur tcatltecprd a NoLtce of Comnnencey ent May esult:fr your paying twIcefc r
improvement snto yotlrproperty A::Notice.of Commence ►ent must be recorc( i end posteii on th.,e fobsite
Before the ftcst inspection If'yu in end td o{rtairt frnaricing,co►isult with lender or an attorney before
commencn ;work'or recardri our Notice of Comrriertcerrtent:
S�gR"
r' ..'.Qwner 'Lessee/Agent Srgoature f ontra, orJticense Hoiden
ST EOE FLQRID STAT OF FLORID
COUNTY OF � � COUNT1f'OF ire z
Ti�efo�r�°mginstrumg.n was aOhowledged before:me The forap�nginstrument:was ackflov+tledged before
"e
ih�s�a!'lday of.. 20 L by the dayOf; 2Q: by
i
(Name rsf arson-acknowledging j {Nau3ie'o perspga0. goW'01gst&
ature df Notary Public-State.of Florida). {S�gn re of Notary Public;State of O ofida.}
Personally,Knowrt LlR Produced Ident�ficabon, Personally Known OR Praduco ldentifkatidn:..
Typeof ldentificatt. n�uced Type of:ldentirication Produced
commission No. . .
;Commission No=:;F flq7tG{4;�E t!N pUlam �� " 8l1MUEt3/►
tVOTAR'lPitHEfC:.. .
NOsTARY PU£UG
Revised b7/15lZW4 t ntlR# 17133
Gc�rt�rriif l~FO1i7433
r :3+ff8 �Etl ' 7 #701' .
REVlEtIYS EROIVT WN1NG SQPERVlSOR. PIANS VEGETATION SEA.TURTLE MANGkOVE
COUNTER REVIEW REVII►IV REUtEtlll REUIEW RE1;fI,E1N`, REI/IEW
DATE.
COMPLETE _...
INITIAIS