HomeMy WebLinkAboutBuilding Permit Application 6HFAII
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PLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: as o1-d�o�1 S
RECEIVE®
Building Permit Applical ion
Planning and Development Services JAN 2 9 70?0
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 ST. Lucie County, Permitting
Phone: (772)462-1553 Fax: (772)462-1578 Commercial _�� Residential
PERMIT TYPE: S� t .5
PROPOSED IMPROVEMENT LOCATION:
Address: 9900 S Ocean Dr 610,Jensen Beach, FL 34957
Property Tax ID#: 4502-503-0064-000-3 Lot No.
Site Plan Name: Block No.
Project Name: Ronald Pinard
DETAILED DESCRIPTION OF WORK:
r9•C4,e> ;0 5 L—) -(
[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:$ �i g� Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Estate of Phyllis J Troth c/o Nancy J Pinard Name:Edward J. Heritage
Address:9900 S Ocean Dr#610 Company:Folding'Shutter Corportion
City: Jensen Beach' State:_ Address:1862,Dr Martin Luther King Jr Blvd
Zip Code: 34957'; :.Fax:N/A':, City: West Palm Beach: State:FL
Phone No.937477-8405= ,i Zip Code: 33404 Fax: 561-640-8204
E-Mail:N/A Phone No 561-683-4811
Fill in fee simple Title Holder on next page(if different E-Mail info@foldingshutters.com
from the Owner listed above) State or County License SCC131151041
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
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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owne Factor as Agent for Owner Signature of Co older
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Palm Beach COUNTY OF Palm Beach
The for oing instrumer was acknowledg d before me The f r Ping instruM=t was acknowledged before me
this day ofy Ra 20by this( day of J 20-�D by
Edward J.Heritage Edward J.Heritage
Name of person making statement. Name of person making statement.
Personally Known xx OR Produced Identification Personally Known xx OR Produced Identification
Type of Identification •Type of Identification
Pro d Produc
(Signature of Notary Pu o F 6131_113 (Signature of N*dm
g� )
o� NOTARY
a STATOFFLORIDAFLORIDA
Commission No. Cprtur GL3282789 Commission No _N
STATE OF FLO,F�2lD3 )
Expires 10/11/2022 CommGG262 �a 10/11/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEATURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 211119