HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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- 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 X Residential
PERMIT TYPE: Window/Door Replacement
PROPOSED IMPROVEMENT LOCATION:
Address: 9650 S OCEAN DR, Unit 1708 Jensen Beach, FL 34957
Property Tax ID #: 4502-610-0112-000-4 Lot No.
Site Plan Name: THE PRINCESS OF HUTCHINSON ISLAND UNIT 1708 Block No.
Project Name: Palmer
DETAILED DESCRIPTION OF WORK:
Install Replacment SGD- 2 openings- non -impact - shutters by others
Install Replacment Windows- 3 openings- non -impact - shutters by others
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: $ 18,500.00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name: Jonathan Starratt
Name Donald M Palmer
Address: 9650 S Ocean DR Apt 1708
Company: White Aluminum
City: Jensen Beach State: _
Address: 2880 SW 42nd Avenue
City: Palm City State: FL
Zip Code: 34957 Fax:
Phone No. 617-799-2126
Zip Code: 34990 Fax: 772-877-2735
E-Mail: don@palmersmail.net
Phone No 772-212-1400
Fill in fee simple Title Holder on next page ( if different
E-Mail astaples@whitealuminum.com
State or County License CGC 1523855
1
from the Owner listed above)
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: Seaside Engineers/Edward Roske
Name:
Address: 4265 Both court
Address:
City: veroBeach State: FL
City: State:
Zip: 32967 Phone 772-202-8008
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 Owner/ esse ontractor as Agent for Owner
Signature of Contra or/Li nse Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF
The forgoing instrument as acknowiedg d afore me
this day of 20�y
The fo,�rggnn}}ng instr men was acknowledged fore me
this 35iay of 20�y
t I, I'C�
Name of person making statement.
Name of person making statement.
Personally Known X OR Produced Identification
Type of Identification
Personally Known OR Produced Identification
Type of Identification
Produced
Produced
(Signature of N16tary Public- State of Flori )
ignatur�of Notla Public- State of FI i a }
Commission No. "12 SeA.6uhlit State of Florida
Angela Staples
My COMM13ston GG 235102
C mission No. 61 L l
� Notary Public State of Flori
•►f" Angela Staples
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PLANS VEGETATION A�fib�Rr�LE tx r p71a412022
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REVIEW
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REVIEW
DATE
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RECEIVED
DATE
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�ev.2/7/19