HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �,.
Date: 8/26/19 Permit Number:�, am` b
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-- - Building Permit Application s��G,i�oeA
Planning and Development Services
Building and Code Regulation Division o„
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial X Residential
PERMIT TYPE: Replacement Door
PROPOSED IMPROVEMENT LOCATION:
Address: 9800 S OCEAN DR 201, JENSEN BEACH FL 34952
Property Tax ID#: 4502-504-0018-000-9 Lot No.
Site Plan Name: ISLAND BEACH CLUB Block No.
Project Name: SHUCKERS#201
DETAILED DESCRIPTION OF WORK:
REMOVE AND REPLACE(1)IMPACT PGT SGD(NOA#17-0420.06)
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit–check all that apply:
_Mechanical _Gas Tank _Cas Piping Shutters J Windows/Doors
_ Electric _Plumbing _Sprinklers `Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 9,100 Utilities: —Sewer `Septic Building Height:
OWNERAESSEE: CONTRACTOR:
NameArk Shuckers Real Estate LLC Name: David LaPrade
Address:%Ark Restaurants Corp85 Fifth Ave Company-The Glass Professionals
City: New York State: 1- I Address:3570 SE Dixie Hwy
Zip Code: 10003 Fax: City: Stuart State:FLIJ
Phone No.610-390-2759 ; Zip Code: 34997 Fax: 772-286-0461 II
E-Mail:rayorwig@orwigproperty.com Phone No 772-286-0459 f
Fill in fee simple Title Holder on next page(if different E-Mail perrnits.9lass ros P @9mail.com
from the Owner listed above)-- State or County License 19363
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 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:
OWNER/CONTRACTOR AFFIDVIT:Application is hereby made to obtain a permit to do the work and installation as indicated.
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
1 in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
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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,1
"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 COMM NNE ENT "T BE RECORDED AND
O�N '#10 F ANCINC, CONSULT
YOU D To E
POSTED ON TUE-40B SITE BEFORE THE FIRST INSPECTION. 11 END T BT
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WITH YPWXENDEA(W*N#1�BEFORE RECORDING YOU��OF CO E119CJEM NT."
Sign A&281�6�'��— Oconttctor as Agent for Owner Signaturkof
STATE OF FLORTt
STATE OF FLORI A
COUNTY OF COUNTY Via H i r)
The orgomg instrument was pcknowledged before me The forgoing instrurpent was acknowledged before me
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this )f 1COAl' b this day of ftLkU 20_LO
day 20L _I by
a P�'C(d C, �oi'10
Name of person making statement. Name of person making statement.
Personally Known / OR Produced Identification Personally Known V OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary PLPI!c-State of Florida (Signature of Notary Pub c-State of Florida
Commission No.(X-72300,9- (Seal) Commission No.68 MD04- (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7F
i, BRENDALOPER BRENDALOPER
COMMISSION
Xp,� J 'y'
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M)'COMNISSION#GG 234007 My COMMISSION#GG 234007
EXPIRES:July 1,2022 EXPIRES:July 1,2022