HomeMy WebLinkAboutApplicationAll APPLICABLE NF MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
15 .
Date: 15.
Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Fierce FL 34982
Phone: (772) 452-1553 Fax: (772) 462-1578
Commercial x Residential
PERMIT APPLICATION FOR:
I
PROPOSED IMPROVEMENT LOCATION:
Address: 7440 S OCEAN DR UNIT 725, JENSEN BEACH, FL 349571
Property Tax ID #:� C -j - (s - r:�JC ' Lot No.
Site Pian Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
rxw ' . L'olvetL! Ic1 of
New Electrical Meter Second Electrical Meter`'
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit- check all that apply:
Mechanical Gas Tank — Gas Piping Shutters Windows/Doors _ Pond
Electric _ Plumbing — Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ U� Utilities:. —Sewer _Septic Building 'Height:
OWNER/LESSEE:
Name Robyn Batson
Address: 3 Palmetto Dr -
City: Stuart State:
Zip Code: 34996 Fax:
Phone No. 954-553-1778
E -Mail: Robyn. batson@gmaii.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed alcove)
CONTRACTOR -
Name: John Cavnar
Company: Goldstar Electric, Inc. -
Address: 213 NE Sagamore Terrace
City:Saint Lucie state: FL
Zip Code: 34983 Fax:
Phone No 2-380-5913
E -Mail johnC oldstar-electric.com
State or County License -_ 23575
If value of construction is 2500 or more, a RECORDED Notice of commencement is required.
If value of HAVC is $7,504 or more, a RECORDED Notice Of Co►ilf encement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
I DESIGNER/ENGINEER: X Not Applicable
Name:
x
MORTGAGE COMPANY: Not Applicable
i _ PP ,
Name:
Address:
Address:
City: State:
Zip: Phone
I City: State:
I Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
BONDING COMPANY: x_Not Applicable
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 thepermit 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 Horne 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: roam 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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of 5t.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attorney before commencing work or recordine vour Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF r y�
rlGiA,
S n to {or affirmed) and subscribed before me of
Ph sicaI Presence or Online Notarization
this day of 14..• 12020 by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
(Signature of Notary Public -
4
Signature cr Contractor/License Halder
STATE OF FL
COUNTY OF _.0 rid`
S n o (or affirmed] and subscribed before me of
hysical Pres nce or Online Notarization
this day of sp 2021 by
John Cavnar
Name of person making statement.
Personally Know'_ OR Produced Identification
Type of Identification
Produced^►
,L5ignature of Notary Public- State of Florida )
uv i�""• EDWARD MOTCH
Commission No. _ z; ::f5ea4btaryPublic-Stateofffor� aCo mission No. ZOu'4l l a unuo�rNE
Commission yGG 113882 LlLSS �JEi tl' "!"'uiUJ00 ,
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REVIEWS FRONT NS VEGETATION A TU
COUNTER REVIEW REVIEW REVIEW REVIEW W REVIEW
DATE
�RECEIVED
DATE
COMPLETED I