HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/23/2015 Permit Number:
1,996 in R E C E FV FE D4
Building Permit Application DEC 2 9 2015
Planning and Development Services PERMITTING
Building and Code Regulation Division St. Lucie County, FL
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: 10102 SOUTH OCEAN DRIVE#703
Legal Description: ATLANTIS CONDOMINIUM BLDG A UNIT 703A AND PRO-RATA SHARE IN COMMON ELEMENTS
Property Tax ID#: 4502-802-0060-000-3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK.
REPLACEMENT OF 30 GALLON ELECTRIC HEATER WITH PAN
CONSTRUCTION INFORMATION
Additional work toe e ormed under this permit—check a apply:
HVAC Ei Gas Tank []Gas Piping _Shutters Q Windows/Doors
Electric ❑✓ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 1,198.00 Utilities: Sewer Septic Building Height:
OU1lNER/LESSEE.: „�1 ,, .. u�g 'e�CONTRACTOR:
Name NATALIYA MUZYCHKA ! + :Name: •RICHARD BASSOFF
-Address:-60.SUR,.STEVENS�DR Company: ,ADMIRAL PLUMBING SERVICES, LLC
City: VAUGHAN State:ON Address: 2895 JUPITER'PARK DRIVE#700
Zip Code: 1_6A OH9 Fax: City: JUPITER State: FL
Phone No.647-800-5544 Zip Code: 33458 Fax:
E-Mail: Phone No. 561 746-1180
Fill in fee simple Title Holder on next page(if different E-Mail:
from the Owner listed above) State or County License: CFC 1426115
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 thepermit 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
com ing work or recording our otice of Commencemen
s
=Signature of Owner/L se gent 4�-Signa"ture of Contractor/ ' e der
__._.,
STATE OF FLORIDA STATE OF FLORID
COUNTY OF PALMBEACH COUNTY OF PALMBEACH
The o'�ang inst: ment was acknowledged before me Thefor ling inst ent was acknowledged before me
this a"day of -CC4✓� 20 _by thisGWdi ay of 1)46� _ ,20 _by
Q'.'a"8 Bac 'a �-(�" &-nbg
(Name of person acknowledging) (Name of person acknowledging)
(Sig ture of Notary Public/-State of Florida) (Sig at of Notary Public-State of Florida)
P:rsonally Known � OR Produced Identification Personally Known �OR Produced Identification
Type of Identification ProducedS ntification Produced
�� �' 5"e SUSAN CLARK STA
Commission No. �I;�7�' 1�'7Z j--
• e,,� MY COMMISSION n No. 1i� f`4f COMMISSION#E 1142
% & EXPIRES Nov em r 13,2018 EXPIRES November 2016
„�„•', com •,��� ,�•••
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS