HomeMy WebLinkAboutBuilding Permit Application I
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: 1 (D o`1((��
• 6221
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
I
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at,the end of line
PROPOSED IMPROVEMENT LOCATION .,
Address: 9490 S Ocean Dr Apt 1012,Jenson Beach, FL 34957
Legal Description: OCEAN TOWERS CONDOMINIUM A-UNIT1012 AND UNDIV SHARE UN COMMON ELEMENTS(OR 767-2304
Property Tax ID#: 3535-701-0075-000-0 ii Lot No.
Site Plan Name: Block No.
Project Name: -
Setbacks Front Back: Right Side: Left Side
DETAILED DESCRIPTION OF WORKf
REMOVE AND REPLACE WATER HEATER 30 GAL.LOW BOY
CONSTRUCCTION INFORMATION: I
Additional work to be nerformedj un ert Is permit-check all Mapply:' h
i
❑HVAC E]GasTank as Piping _Shutters Windows/Doors
Electric ®Plumbing Sprinklers Generator III Roof Roof pitch
Total Sq. Ft of Construction: S . Ft.of First Floor:!'
Cost of Construction:$ 800.00 utilities Sewer osl�
ptic !,Building Height:
I
OWNER/LESSE,E CONTRACTQR w
Name ALICE T O'KEEFE Name: ADAMSAMPSON
i,
Address: 9490 S OCEAN DR.APT 1012 Company: SOUTHPAW PLUMBING AND METERING SERVICE
City: JENSEN BEACH State: FL Address: 1458 SW BARTELLAVE.
Zip Code: 34957 Fax: City: PORT SAINT LUCIE State: FL
Phone No. Zip Code: 34953 ; Fax:
E-Mail: Phone No. 772-486-0914
Fill in fee simple Title Holder on next page(if different E-Mail: ADAM@SOUTHPAWWATER.COM
from the Owner listed above) State or County License: CFC 1428285
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
I
I
ii
SUPPLEMENTAL CONSTRUCTION LIEN LAVI/ INFORMATION: 1 Y
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 attorney before
commencing wor or recor_Cling your blotice of Commencement.
S
Signature of Owner/Lessee/Contractor as Agent for Owner Signature o ntractor/License Holder
i
STATE OF FLORIDA STATE OF FLO A
COUNTY OF Sji�.y COUNTY OF ��, n16:c -
The forgoing instrument v)as acknowledged before me The for oing instrument was acknowledged before me
this-, ` day of 20 Eby this day of 20 by
aclah= so Pw-) Ima on I 3 Chi lost) r)
(Name of person acknowledging) (Name of person acknowledging)
(Sig ture of Notary Public- tate of Florida) (Signature of Notary Public-State of Florida)
Personally Known OR Produced Identification Personally Known OR Prod}tGed Identification X
T of I entification Produced Type of Identification Produced I— LQ L
�/� I
Commission No. Commission No.T
2u
20* "�o�•, ASH IV
GRAM �,�°" sLim"Wa N fpsmN
Notal p
Y ublic-State ='P Florid
"�F «o,4F Co M. xpires Dec 20,2018 g �r Comiitltslm-#FF 240832
Revised 07/15/2014 '°,o}F� mmission#FF 177249 ;��� My Comtn.fxplros Jun 16,201
"""' Bonded
through Natio
nalNotar
Y Assn,
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS