HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 'aN` 5 1 Permit Number:
RECEIVED
SEP ® � 2019
o m -
- Building Permit Applicatio Lucie County, Permitting
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 'Ta.t nhme)
PERMITTYPE:Window replacement (6) ��-�.� Docs
PROPOSED IMPROVEMENT LOCATION:
Address: 9425 S OCEAN DR, BLDG 9, UNIT 65, JENSEN BEACH, FL 34957
Property Tax ID#: 3535-333-0001-770-0 Lot No.
Site Plan Name: ISLAND VILLAGE Block No.
Project Name: ROSEMAN
DETAILED DESCRIPTION OF WORK:
REMOVE AND REPLACE 6 WINDOWS WITH IMPACT RATED WINDOWS
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction: Utilities: —Sewer _Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name KAITLYN M ROSEMAN Name:JON LEVASSEUR
Address:9425 S OCEAN DR, BLDG 9 UNIT 65 Company:EDEN SCREEN &CONSTRUCTION CO., IN
City: JENSEN BEACH State:_ Address:1997 SE ESTERBROOK ST
Zip Code: 34957 Fax: City: PORT ST LUCIE State:FL
Phone No. Zip Code: 34983 - Fax:
E-Mail: Phone No772-216-6171
Fill in fee simple Title Holder on next page(if different E-Mail EDEN68@AOL.COM
from the Owner listed above) State or County License CBC 059494
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 TITLEHOLDER: _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
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 NAY RESULT IN-YOUR PAYING
TWICE FOR IMPROYEMENTS, TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SFFE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH,YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE.OF COMMENCEMENT."
I oani '
Sig ture of Owner/Lessee/Contractor as Agent for Owner Si nature of Contractor 'cense Holder
STATE OF FLORIDA � n STATE OF FLORIDA
COUNTY OF COUNTY OF
The forgoing instrument was acknowledge before me The forgoing instrument was acknowledged 4efore me
this 2Q day of nlia20 r` by this ay of 20_&y
Name of person making st a ent. / Name of person making statement.
Personally Known OR Produced Identification!/ Personally Known OR Produced Identification
Type of Identification Type of Identification ��
Produced ,EL �, Produced
Wait
(Signatur - Florida (Signature of
, rELLEN VAU jj��II�� ��"1YP��i ELLEN VAUGVN
Commissi ° S Ida-Not951L Commission N ?11°�Pa Ue`��State of Florida-0139a Public
blic Commission # GG 270079
Commission # GG 270079
My Commission %�Fo, roQ, My Commission Fx ires
of bar 22, 2022 " cto er22, 22
REVIEWS ERVISOR PIANS VE G OVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19