HomeMy WebLinkAboutBuilding Permit Application 1
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 31 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: To Select from dropbox, click arrow at the end of linelz,*,te r
PROPOSED IMPROVEMENT LOCATION:
Address: 3870 N HIGHWAY A1A APT 1003, FORT PIERCE, FL 34949
Legal Description: HIBISCUS-BY-THE-SEA CONDOMINIUM BLDG 1 UNIT PH 3 (OR 1039-2264)
Property Tax ID#: 1423-805-0055-000-3 Lot No.
Site Plan Name: Block No.
Project Name: C 7S e_,-laCA-
Setbacks
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Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
WH CHANGE OUT Lp GA-L �U_ L
CONSTRUCTION INFORMATION:'
Additional work to benerformed un er this permit—c ec a appy:
HVAC Gas Tank []Gas Piping _Shutters Windows/Doors
Electric 0 Plumbing Sprinklers El Generator E] Roof
Total Sq. Ft of Construction: SFt. of First Floor:
Cost of Construction: $ 500 Utilities:,nSewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name QI e✓ t4 Name: ERIC NERENBERG
Address: 2S I ` W c 414 1003 Company: SERVICE AMERICA
City: -FD lle/'Ce_ State:FL Address: 2755 NW 63RD CT
Zip Code: �1 2 Fax: City: FT. LAUDERDALE State:FL
Phone No. /02� ✓s) r�s Zip Code: 33309 Fax: 954-977-3591
E-Mail: C Phone No. 954-979-1100 X5673
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: 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:
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 ttorney before
commRVcJng wcWk or r ordi our Notice of Commencement.
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STATE OF FLORIDA STATE O_FLORI -�
COUNTY OF c r i COUNTY OF Lward
The forgoipg instrument was acknowledged before me The forgoing instrument was acknowledged before me
this,W6ay of 14311,121:J_ 20 Eby this__a_day of ,20 by
ERIC NERENBERG
(Name of person acknowledging) (N a of person aclri ! gIn�1A9�J®
! CQPAMIgS10N 21.2020
ignature of Notary Public-State of Florida) (Signature 4 Nota ¢n rl a)
Personally Known OR Produced Identifica on Personally Known CR
Type of Type of Identification IP rim
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Commis 4 :�;;Notary Public-State
Fl Id -�: � ' EXPIRE my 21,2020
S My C0111111.Expires Sgpp, 16 Commission No.
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
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