HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ` / ,/� �C
Date: Permit Number: 1(0 Os m
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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: Mechanical
PROPOSED IMPROVEMENT
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Address: 274 NETTLES BLVD
Legal Description: NETTLES,ISLAND INC,A CONDO-SECTION II PARCEL 274 ANDPRO-RATA SHARE IN COMMON ELEMENTS(OR 3223-635)
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Property Tax ID#: 4502-501-0460-000-3 Lot No.
Site Plan Name: John F Rocha Cidalia C Rocha Raymond J Rocha Block No.
Project Name: John F Rocha Cidalia C Rocha Raymond J Rocha
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTIONrOFV1/ORI< .`fx
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AC CHANGE OUT 2TON 14SEERS 7.5 KW
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CO_ NSTRUCTION INFORMATION a �`.� � �
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Additional work to be nerformed un er t Is permit—check all that appy:
HVAC _Gas Tank FGas Piping _Shutters ❑Windows/Doors
Electric ❑_Plumbing Sprinklers M Generator Roof
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Total Sq. Ft of Construction: S Ft. of First Floor:
Cost of Construction:$ 3500.00 Utilities:DSewer OSeptic Building Height:
OV1/NEFt`/LESS;,`,- f fit' "CO CTOR u' F
Name John F Rocha Cidalia C Rocha Raymond J Rocha Name: RICHARD LEVINSON'
Address:274 NETTLES BLVD Company: SERVICE AMERICA
City: JENSEN State:FL Address: 2755 NW 63RD COURT
Zip Code: 34957 Fax: City: FORT LAUDERDALE _State,FL
Phone No.401-480-2089 Zip Code: 33309 _ Faxc 954-977-3591
E-Mail: Phone No. 954-979-1100 l
Fill in fee simple Title Holder on next page ( if different E-Mail: EPERMITSGROUP@SERVICEAMERICA.COM
from the Owner listed.above) State or County License: CAC014619
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If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLE�MENTALxCON`STR�UECTION LIEN LAV1/,INFORMATION�' �� �� '' '�''_ � y � ���
� .-......�:'.. r �, °` a �4 r, i. -' ;�... ..�;. U� .fir. ��-.,. .,� s �" . use ., •, it`. ,..r%" ,? a51 ,
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: ' Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
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FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: 1 Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip:_ Phone:
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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 yourdeed for any restrictions which may apply.
In consideration of the granting of this requested permit, I d0h E!reby agree that I will, in all respects, perform the work
in accordance with the approved plans,the Florida Buil g Codes and St. Lucie County Amendments.
The following building permit applications are exempt from ndergoing a full concurrency review: room additions,
accessory structures,swimming pools,fences,walls,signs,scr n rooms and accessory uses to another non-residential use
(WARNING TO OWNER: Your failure to Record a Notice o o mencement may result in your paying twice for
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pr vements to your property. A Notice of Commenc t must be recorded and posted on the jobsite
e o the first inspection. If you intend to obtain financin sult with lender o;r an attorney before
cin work or recordingour Notice of Comme e
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_Si atu: Ov tier/ seeJAge't° SI attire of Contr`actor/L�i_, .ceras-e�"Woider
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF SAINT LUCIE COUNTY OF SAINT LUCIE
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The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this day of 20 by this day of s 20 by
RICHARD LEVINSON _� { RICHARD LEVINSON
(Name of person ckn wled ing (Name of perso ac k o e Ing) �z _
ti 47'a I• �_ry
r a.G7 L FZ.41 O� E D.OEni • _ uia
(Signatu N Trl - ateri}� (Siature of ota u lic-State of oa�LU N
LU Q 131 Q-
Per onally Kno nOR Pro' uc�-r ification ersonally K own OR Produ F e�'t ' ation
Ty e of Identif' auced "' ype of Ide ification Produced .Iw-
:ai;••±Yp JCL�}��"si..��
60% tea
Comm" io o. �
Commission No.
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Revised 07/15/2014
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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DATE
COMPLETE
INITIALS
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