HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED j (} pc�3 t ,
Date: 4-26-19 Permit Number: I 011 -
Building Permit Application
Planning and Development Services .��� 1 9?019
Building and Code Regulation Division went
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x Residential
RECEIVED
PERMITTYPE: COMMERCIAL
PROPOSED IMPFOUEt17;ENT kQCATiION t;
Address: 10410 SOUTH OCEAN DRIVE JENSEN BEACH, FL 34957
Property Tax ID q: 4511-514-0000-000-9
Site Plan Name: HUTCHINSON ISLAND CLUB
Project Name: MDF
Install communication equipment in existing room
Additional work to be performed under this permit — check all that apply:
XMechanical _Gas Tank _Gas Piping _Shutters
X Electric _ Plumbing _Sprinklers _ Generator
Total Sq. Ft of Construction: 56
Cost of Construction: $ 15000
Sq. Ft. of First Floor:
Lot No.
Block No.
_ Windows/Doors
Roof Pitch
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE z + .c. ` .xbuW wax
JF
CONTR�`AC^T,QRs rxr „k F A
Name
Name:
Address:
Company:AVA CONSTRUCTION INC
City: State: _
Zip Code: Fax:
Phone No.
Address:1266 MARINA POINT 17-112
City: CASSELBERRY State: FL
Zip Code: 32707 Fax:
Phone No954 381 9789
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail avaconstructioninc@yahoo.com
State or County License CGC1514186
If value of construction is $2500 or more, a RECORDED Notice of Commencement is regwrea.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
DESIGNER/ENGINEER: _ Not Applicable
Name: TYRONEwESCART
MORTGAGE COMPANY:
Name:
_ Not Applicable
Address: 1109 RIALTO OR
Address:
City: BOYNTON BEACH State: FL
Zip: 33436 Phone3053439664
City:
Zip: Phone:
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY:
Name:
_Not Applicable
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 RECORPING XWR
NOTKE OF COMM
NCEMENT."
)
Signatufe of Owner/ Lessee/66ritraactor as Agent for Owner
Si ure of (fdntractor/44cense Holder
STATE OF FLORIDA
COUNTY OF _E>1fOW
STATE OF FLORIDA
COUNTY OFBROWARD
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The fot �oing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this-F�- day of by
this 29 day of APRIL 2019 by
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NIQr; i Y1 l • 1 oh
JILLIAN RAGOONATH
Name of person making statement.
Name of person making statement.
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
AND(iislonO0ERS0N
Pro ced •" •••• MARIACLINTON
,F; *+. Notary Public - StateofFlorida
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roduced R253423 767870 YO(t�
+ CommlealonkGG2T015T
ExplreBFebruary 22,2023
CommissionIGG136609
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(Sig ture of Notary Public-��
ignat Notar Pub' - to of Florida )
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Commission No.�aIPLO (Seal)
Commission No. (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
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REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 2//119