HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED l
Date: /J ' lJ Permit Number: /J— 421C
RECEIVED-
Building Permit Application
Planning and Development Services JUL 15 .2015
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED:IMPROVEMENTLOCATION:
Address: 854 SE CORTO TERR
Legal Description: RIVER PARK-UNIT 7-BLK 65 LOT 5
Property Tax ID#: 3419-550-0044-000-5 Lot No.
Site Plan Name: Gary Schloerb Judith Schloerb Block No.
Project Name: Gary Schloerb Judith Schloerb
Setbacks Front Back: Right.Side: Left Side:
DETAILED DESCRIPTION .OF,WORK ,Y
AC CHANGE OUT 3TONS 16SEERS 10KW
CONSTRUCTION- INFORMATION:
Additional work to be nertormed under tispermit—check°all that appy:
HVAC Gas Tank []Gas Piping _Shutters Q Windows/Doors
11 Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 4500.00 Utilities:Sewer Septic Building Height:
OWN ERAESSE- : . CONTRACTOR- -
Name Gary Schloerb Judith Schloerb Name: RICHARD LEVINSON
Address:854 SE CORTO TERR Company: SERVICE AMERICA
City: PORT SAINT LUCIE State:FL. Address: 2755 NW 63RD COURT
Zip Code: 34983 Fax: City: FORT LAUDERDALE State:FL
Phone No.775-877-3185 Zip Code: 33309 Fax: 954-977-3591
E-Mail: Phone No. 954-979-1100 EXT 5673
Fill in fee simple Title Holder on next page(if different E-Mail: epermitsgroup@serviceamerica.com
from the Owner listed above) State or County License: CAC014619
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CON STIR LIE3N LAV1/ INFORMATION: #
� , "
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEESIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: 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 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 use /to another non-residential use
(WARNING TO OWNER:Your failure to Record a Notice of Co m cern ma result in your paying twice for
te
\fr
Chc
ents to your property. A Notice of Commencem t m st e r c rded and posted on the jobsite
first inspection. If you intend to obtain financin con ul wit ender or an attorney before
i work or recordingour Notice of Commence nt.
! �� u A_ s
SIg tu�roQwner/Cess_eeg—Jenf Signa u e of Contr c o'r%License Holder°
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SAINT LUCE COUNTY OF SAINTLUCE
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20 _by this 13 day of 7 20 by
RICHARD LEVINSON RICHARD LEVINSON /
(Name of person ack led Ing (Name of person af w/ledging)
s
(Si nature of No ary Pu i State of Florida) (Signature N t izy- c-State of Florida)
f
PeYsonally Kn n x R Produc n Person I y Know x OR Produced Identification
T pe of Iden Ifiri ,ON Typ f Identific tion Produced
,• Y r�4'% MY COMMISSION#FF 0722017
Co Ion No. =*i '•*` IRES;Novetl> n �rhers Commission N .4 SICADOTSO eal)
Bonded Thru Notary PabbT� r ti g Nly COMMISSION#FF 072984
�'Qf" *' EXfgIRES;November 25,2017
'ie• - $,X Bonded Thru NotarY Ronc unuut
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS