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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: _,;� 5 Permit Number: &9-6 4�2
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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 Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line
PROPOSED IMPROVEMENT LOCATION:
Address: 8750 S Ocean Dr. Unit 1131, Jensen Beach FL 34957
Legal Description: 1EACLod di-ne-S Qoncbrn'Ir1i L1rn -Pr L tni t 1131 A J K ,R
Property Tax ID#: Lot No.
Site Plan Name: j�'1� mi t Condo Block No.
Project Name: 0Rab\inn
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Rer"o,re ay1d i epWe 6i ioJf n(9 DJ a_sS d00 r ' M Pa"C-"
CONSTRUCTION INFORMATION:
Additional work to be performed under t ispermit—check all appy:
HVAC Gas Tank E]Gas Piping Shutters indows/Doors
Electric 0 Plumbing Sprinklers 1:1 Generator F] Roof
Total Sq. Ft of Construction: T�•3 "�' Sq. Ft.of First Floor:
Cost of Construction:$ T Cn Utilities:Sewer E]Septic Building Height:
OWNER/LESSEE: CONTRACTOR: .
Name Craig Crawford Name: DM LCAnC,1e
Address:8750 S Ocean Drive#1131 Company: the Ohm Pmk-_gs`GrGls
City: Jensen Beach State:FL Address: 3570 SSE DINi e -44VVW
Zip Code: 34957 Fax: City: ShAar_� State: FL
Phone No.+1 (678) 777-5897 Zip Code: 3L'997 Fax: 77a.•a$b'0%1
E-Mail:craig.crawford@yahoo.com Phone No. -17oZ• -1W,-045cl
Fill in fee simple Title Holder on next page(if different E-Mail: r' ` •COrn
from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE 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 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 - ded and sted on the jobsite
before the first inspection. If you intend to obtain financing, cons wit, h len er or 9fi d1ttorney before
commencing work or recording our Notice of Commencement i
s
_Signature/of Owner/Lessee/Agent-,' Signat 're of ont•actor 'ce er _..
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF M ?/ COUNTY OF I_y?ar h ,a ,
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this��ay of 20 Z�by this J day of 20 La by
(Name oTpr6rson a knowledging) (Name of person acknowledging)
(Signat retary Public-State of Florida) (Signatur of o ry P li tate of Florida)
��. a' I �
Personally Knn OR Produced Identi t o�E A ljsonally Know DR Prol &'Vde
Type of Identification Produced 1 1i�s^,`i i�fAR j�. �POof Identifica a�n cice A tON#EE'122580
i EXPIRES October 01,2015
Commission No. )� (Ss'gl) My Oomm.Expir sComrission No. F � �•�,,,
March 22,201
• No.FF 92502
Revised 07/15/2014 �i '9T%-pqB�'�G'OQ\O``
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