HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ]� ��yy qtr
Date: Permit Number:
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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: Plumbing
RROPOSED IMPROVEMENT LOCATIOWr .
Address: 9600 S OCEAN DR 1006
Legal Description: EMPRESS CONDOMINIUM UNIT 1006 (625-1496)
Property Tax ID#: 4502-620-0078-000-4 Lot No.
Site Plan Name: Romola Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
[DETAILED DESCRIPTION OF WORK:
WH CHANGE OUT q® �0 C'C�
CONSTRUCTLON'INFORM'ATION: .
Additional work toe e orme under this permit—check a appy:
HVAC E] Gas Tank []Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: S . Ft. of First Floor:
Cost of Construction:$ � �d Utilities: Sewer Septic Building Height:
OWNER/LESSEE:, CONTRACTOR:
Name Theresa&Thomas S Romola Name: ERIC T NERENBERG
Address:9600 S OCEAN DR 1006 Company: Service America
City: JENSEN BEACH State:FL Address: 2755 NW 63rd CT
Zip Code: Fax: City: Ft. Lauderdale State:FL
Phone No. Zip Code: 33309 Fax: 954-977-3591
E-Mail: Phone No. 954-979-1100
Fill in fee simple Title Holder on next page (if different E-Mail: EPERMITSGROUP@SERVICEAMERICA.COMC
from the Owner.listed above) State or County License: CFC056891
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL"CONSTRUCTION LIEN ,LAW INFORMATION-
DESIGN ER/ENGI NEER:
NFORMATION: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 recorded and posted on the jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an ttorney before
comme n work or recordingour Notice of Commencement.
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ignature-of- ;Le eL gentSTgnature` G-10,t- c or/�License Holder
STATE OF FLORIDA - STATE OF FLORI A@@ G�
COUNTY OF 4- COUNTY OF J
The forgoing instrument was acknowledges(b 16re me The forgoing instrument was acknowledged beef re me
this:7 day of / �/ 20 JC by this ` day ofJ�GLTf'� �--,20 by
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(Name of person acknowledging) (Name of person acknowledging)
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(Si tur otary Public-State of Florida) ��eirsonalf
e f otary Public-State of Florida ) AO m
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Personally Known `� OR Produced Identification y Known OR Produced Identific c 7 O
Type of Identification Produced . Type of Identification Produced a r_ rn ? o
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Co isidn�iVo. MPBE11e I) ] o g' 1k c7
Commission No. ;. •, aa
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°A WAY NE MORRIS CAMPBELL i F132553
'`. MY CC) 59 ;.;< �,:�;,; 15. 2010
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Revised 07/
d?=' EXPIRES June 15,2018 (407)ase-u1 "..,N
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DATE
COMPLETE
INITIALS