HomeMy WebLinkAbout1609-0187ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 09/02/16
Permit Number:
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
Address: 9500 S Ocean Drive 1902
Legal Description: Islandia II Condominium Unit 1902
Property Tax ID #: 4502-602-0176-000-5
Site Plan Name:
.✓
Lot No.
Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
[AILED DESCRIPTION OF WORK:
�0Y �19 wa-fe�C�-l� l:V� �liL 1�Q�fYI
40 Tl(o n Oec+r c w of
CONSTRUCTION INFORMATION:
Additional work toa performed under this permit — check a appy:
HVAC 11 Gas Tank OGas Piping _ Shutters Windows/Doors
11 Electric 0 Plumbing Sprinklers FIGenerator Roof Root pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 350.00
S'C Ft. of First Floor: _
Utilities, Sewer 0 Septic
Building Height:
OWNER/LESSEE;
CONTRACTOR:
Name Kathleen M. Westfall
Name: Joseph S. Brownlow
Address: 9500 S Ocean Drive., Apt 1902
Company: Premier Plumbing and Air, LLC
City: Jensen Beach State: FL
Zip Code: 34957 Fax:
Phone No. 772-221-9615 J (Qg
Address: 108 NE Dixie Hwy.
City: Stuart State: FL
Zip Code: 34994 Fax: 772'692-1094
Phone No. 772-692-2500
E -Mail: preplbgac@gmaii.com
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License: A5b[ g
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
�IJPREfl RUITT;�C1
L 1�STRKTION LIEN LAIN INFORMATION:
„ 177,
DESIGNER/ENGINEER: X Not Applicable
Name: _
Address:
City:
Zip:
Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Zip: Phone: _
State:
X Not Applicable
MORTGAGE COMPANY: X Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: X Not Applicable
Name:
Address:
City:
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 attorney before
commencing work or recording vour Notice of Commencement. ,,
Signature of
ctor as Agent for Owner
ctor
STATE OF FLO IDA STATE OF FLOD
COUNTY OF i.�.hb 1r COUNTY OF �
The f�{�ing instr men wa acknowledgeyl`before me
this �( day ofi' 20 /(a� by
(Name of per§on acknowledging)
0�f u A—abo
-
(Signature of Notary Public- State of Florida )
Personally Know ' '
Type of Identifica ' ' MYSTAL A QUEVEDO
MV COMMISSION 0 FF904048
Commission No. ' EXPIRES J*311� 2019
(401) 39M'b3 FIori WfMySwv1o@.=r.
Revised 07/15/2014
The forgog'ng instr ent was acknowledged before me
this_ �l"day of 20 -(a by
urn IMO
(Name of person acknowledging )
0 - 6L�Uto
(Signature of Notary Public- State of Florida )
Personally Known 4?t_
ocI0W08ftif��ev
Type of Identification P EXPIRES 31.2019
Commission No.F o �oa+,
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