HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I
Date: �� Permit Number: ' Ol U t0
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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 x
PERMIT APPLICATION FOR:
To Select from dropbox, click arrow at the end of line 5}` 5
PROPOSED IMPROVEMENT LOCATION:
Address: 10200 S Ocean Dr Jensen Beach FI 34957 Unit 509
Legal Description: Atlantis III by the sea unit 509
Property Tax ID#: 4511-518-0047-000-2 Lot No.
Site Plan Name: Block No.
Project Name: Accordion Shutter
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Install one accordion shutter on the balcony. Ad lmpavf 5r(1d/_J5 do0 f AP
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CONSTRUCTION INFORMATION:
Adclitional work to benerformed under this permit—check all appy:
HVAC Gas Tank r—iGas Piping _Shutters ✓�Windows/Doors
11 Electric 0 Plumbing OSprinklers ❑Generator ❑ Roof
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction;/ ' 9,yoa 00 Utilities.
Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Laura Zebib Name: John Zervopoulos
Address:3691 SW Canoe Creek Terr Company: Advanced Hurricane Protection
City: Palm City State:Fl Address: 4517 SE Commerce Ave
Zip Code: 34990 Fax: City: Stuart State:FI
Phone No.772-370-3205 Zip Code: 34997 Fax:
E-Mail: Phone No. 772-220-1200
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: CBC1259339
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 fail re to Record a Notice of Commencement may result in your paying twice for
improvements to your propert A Notice of Commencement must be recorded and posted on the jobsite
before the first ins 'on-1f'y- to obtain financing,consult with lender or an attorney before
commenci or ecordin our Notl of Commencement.
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_Signature of Owner/Lessee/Agent Sig ure of 91ractor/Liegnse Holder
STATE OF FLORIDA STATEOF LORIDA
COUNTY OF - �.1 ;r� COUNTY OF__-
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this S1 day of 20 ( by this_day of V 20 \5 by
(Name of person acknowledging) (Name of person acknowledging)
(Signature of Notary Public=State'offlorida) "{$tgnature of Notary Publi tate of Florida)
Personally Known OR Produced Identification )C Personally Known p iR n
Type of ldentiflcatio Type of ldentificat Q ucd L _. _mate
PAY PbeN°tory
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MYCOM #FF20643
8781Commission No. Commission No. EE 8
ExPIR M��rch 06.2019
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,rcisye-c so fbriGo!Wta Jgenicc cur ''1;e of F�;:'� 9onded Zhtou9 �"•r:" '
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS