HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ++ --
Date: Permit Number: 1,5I O - 002 P
n N:
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 XXX
PERMIT APPLICATION FOR: Window/door
PRQPOSED IMPROVEMENT LOCAT'
ICI�IUy
Address: 10200 South Ocean Drive, #404
Legal Description: Atlantis III By The Sea Unit 404 and Pro-Rata Share in Common Elements
Property Tax ID#: 4511-518-0032-000-4 Lot No.
Site Plan Name: Block No.
Project Name: Colleen Loyot
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION C3F WORK
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Remove and replace windows at (2) openings at front of unit.
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CONSTRUCTIQN INFClRM,ATION„ ry y
Additional work to be nerformed under this permit—check all appy.
HVAC Gas Tank []Gas Piping _Shutters �✓ Windows/Doors
OElectric Plumbing OSprinklers I3 Generator Roof
i
Total Sq. Ft of Construction: S Ft. of First Floor:
1200.00
Cost of Construction: $ Utilities: Sewer aSeptic Building Height:
OWNER/LESSEE CONTRACTOR. a
N e �:, ... Namet3,.F;? ,� c �' .,,�,:,�:;. I`4. ,.0rrif D.
A rss vri << }eta ,t Coti{aa4�!a
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.i:,+aa �IFart,Folercel!t 4,qu.d' eJ
ih. t.9Ji!7Ud;f.e3ig+ Fax:S+ +'' • YGtty: a� '44j4T" f//s - s State'
467-6650
Phone No. Zip Code: - Fax:
(772)370
! E-Mail: Phone No.
Fill in fee simple Title Holder on next page (if different E-Mail: trUs CO a sou 25
90
i from the Owner listed above) State or County License:
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
-777'77777 777
777� RE
rSUPPLEMENTA �NSTU f�N LIEN LAUi/; iNF�R /IATIC3N
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: Xy 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 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 recording our Notice of Commencement.
' s
_Signature of Owner/Lessee/Agent Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA �,� 1 l
COUNTY OF r( / COUNTY OF / Yl A iPN
The f r oing instrui ent as act-now dged b ore me The forgoing instru ent was ac cnowledged fore me
this day of 20 y this�day of (/20 �by
/R Q e-he L A ,f o w, o �T of&P_) �ia�o
(Name of person acknowledging) (Name of erson acknowledging)
"Ll C�A LL L11- A aoid'26uv k__
(Signature of Notary Public-State of Florida ) (Signature of Notary Public-State of Florida )
Personally Known�✓OR Produced Identification Personally Known OR Produced Identification
Type of Identification Pr' Type of Identification Produced
ICRAN ERASER Ii ERASER
Commission No. k-State ofFlorMa Commission No. a�""'�� 1
�. �.8We of FJA
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slon N FF 197063 +� C"o nit"0 FF 197m.Expires May 19,2019'•uu� dsoio tial Iotial Notary Assn.. ar MY wr
Revised 07/15/2014-
REVIEWS
7/15/2014REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS