HomeMy WebLinkAboutApplicationLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED er.
,All APF Permit Numb
Date: August 24,2020
L _IICL
Building Permit Application
Planning and Development Services commercial X Residential
�
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
j PERMIT APPLICATION FOR: Renovation
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Address: 9650 South Ocean Drive # 1003, Jensen Beach, Florida 34957
Property Tax ID #:
4502-610-0093-00/4 Lot No.
Block No.
Site Plan Name:
Project Name: C 1
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I�FTAI
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Renovate Kitchen. New Cabinets. All Plumbing to remain in same location. Electric access to remain in same location for
12 volt overhead lighting. Arc Flash GFCI breakers installed/ replaced in Panel for Kitchen. J ��
New Electrical Meter Second Electrical Meter
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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 Pitrh
Total Sq. Ft of Construction: 126
Sq. Ft. of f=irst Floor:
_
Cost of Construction: $ 19,800.00 Utilities: —Sewer
— Septic
O`N 0r'
Salkinr"arneHarol'dName:
Address: 9650 South Ocean Drive # 1003
City: Jensen Beach, Florida
Company:
State:
Address:
Zip Code: 34957 Fax:
Phone No. 561 714 8847
City.
clacor _
E -Mail: p@bellsouth.net
Zip Code:
Fill in fee simple Title Holder
Phone No_
_
on next page ( if different
from the Owner listed above)
E -Mail
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
Building Height:
4
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1
State:
_ Fax:
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A.
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5UPPL�MENYAL CION'.
DESIGNER/ENGINEER:
Name:
Address:
City:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Not Applicable
Name:
Address:
City:
Zi • Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
F'
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 pe
St. Lucie County makes no representation that is granting a permit will authorize
orae permit hold ter hat mayto d the uboe t st bit such
ructure
which is in conflict with any applicable Home Owners Association rules, bylaws
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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and postedn the jobsite before the first inspection. If you intend to obtain financing, consult
with lefider or an attorn4V before commencing work or recording your Notice of Commencement.
Signature of Owner/ Lessee/C ntractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORI STATE OF FLORIDA
COUNTY OF , LIA r a_ COUNTY OF
Scorn to (or affirmed) and subscribed before me of
X Physical Presence or Online Notarization
this day of2020 by
Name of person making statement.
Personally Known ()� OR Produced Identification
Type of Identification
Produced_
(Signature of Notary
Commission No.
REVIEWS I FRONT
COUNTER
DATE
RECEIVED_
DATE
COMPLETED
eve. 7P77—
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of 2020 by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
YII,MD.ERICKSON (Signature of Notary Public- State of Florida )
,? W COMMISSION # GG 234W
E*k&l6 "31,2022 Commission No. (Seal)
Bonds/ Thm Notary Pubk ftw*rkwa
R
ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW I REVIEW
- - REVIEW
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Planning & Development Services Department
,.. �, ., , ;. <�....11;,,�.,.,. Building & Code Regulations
C'
2300 Virginia Avenue
Fort Pierce, Florida 34982
(772)462-1553
OWNER/BUILDER AFFIDAVIT DISCLOSURE STATEMENT
F.S. 489.103 (7) EXEMPTIONS
State law requires construction to be done by licensed contractors. You have applied for a permit under an
exemption to that law. The exemption allows you, as the owner of your property, to act as your own contractor even
though you do not have a license. You must provide direct, on-site supervision of the construction yourself You
may build or improve farm outbuildings, a one -family or two-family residence for your use and occupancy. You
may also build or improve a commercial building at a cost not exceeding $75,000.00 as long as it is for your own
use or occupancy. You may not build or improve said structures for the purposes of selling or leasing that building.
You may not hire an unlicensed person to act as your contractor or to supervise people working on your building; it
is your responsibility to make sure that people employed by you have licenses required by state law and by co my
or municipal licensing ordinances.
Initial Here.
If you sell or lease a building you have built or improved within one year after construction is complete, th a
presumption is created that it was built or improved for sale or lease, which is a violation of this exemption. r, 1�
Initial Her
You may not delegate the responsibility for supervising work to a licensed contractor who is not licensed to perform
the work being done. Your construction must comply with all applicable laws, ordinances, building code and
zoning regulations. Initial Here
1 understand that the building official and inspectors are not there to design or give advice on how to me the
minimum code. Initial Here.
I understand that as an owner -builder that any contract disputes with sub -contractors and I must be handle n civil
court with the advice of an attorney. This department will. not mitigate any contract disputes.
Initial Her .
I understand that if I compensate any person or company for work performed they are required to be licensed in this
jurisdiction. If for some reason they do not possess a license, I may be responsible and liable for the cost f the
license.
Initial Her
I understand that if any person that is unlicensed and uninsured gets injured on my construction project -they may be
entitled to workmen's compensation. 1 could be held liable for all doctor, lawyer and related inedical cost, ', hich
could include loss of wages during recovery from their injury.
Initial Here.
To qualify for this exemption under this subsection, an owner must personally appear. sign the buildin ennit
application, and initial the above
1 hereby acknowledge that 1 have read and understand the above disclosure statement and that I urther understand
that any violation of the terms of the owner/btulder exemption shall be ported by the B ding and Zoning
Dcpartment to the Florida State Department of Professional Regulation. Si ed and ac. owle ed on this
day of of 20_
STATE OF FLORIDA O� i �a e
COUNTY OF L-yti t -t a
The fc egoin J insh 11Vt'ils acknowledged before me thisby �oG�.-o�I h � day of �
produced who is personally known to me, or who has
as idcnt
Ec�c;E"e� TIMOTHY D. ERICKSON
Signature of Notary " ABY cowas ION # GG 23407
hype or Print Name of Notary-.�,ol�o;�`,,r EXPIRES• 31, 2022
Title: Notacv Public Commission Number BomwT% ,
Underwiders
NOTICE OF COMMENCEMENT
Property Tax ID No. 4502-610-0093-00/4
Permit No.
State of Florida, County of St. Lucie
The Undersigned hereby gives notice that improvement will be made to certain real property, and in accordance with
Chapter 713, Florida Statutes, the following information is provided in this Notice of Commencement.
Legal Description of property and address if available
9650 South Ocean Drive #1003 Jensen Beach FI 34957
The Princess of Hutchinson Island. Unit # 1003
General description of improvements Renovation/Kitchen
Owner/lessee Harold Salkin
Address 9650 South Ocean Drive #1003 Jensen Beach FI 34957
Interest in property: Owner
Fee Simple Title holder (if other than owner)
Address
Contractor Owner Builder Phone # clacorp@bellsouth.net
Address Fax #
Surety Phone #
Address Fax #
Amount of Bond
Lender Phone #
Address Fax #
Persons within the State of Florida designated by Owner upon whom notices or other documents may be served as provided
by Section 71.3.13 (a) 7., .Florida Statues:
_Name Harold Salkin Phone # 561 714 8847
Address 9650 South Ocean Drive #1003 Jensen Beach FI 34957 Fax #
In addition to himself, owner designates of
Phone # Fax #
to receive a copy of the Lienor's Notice as provided in Section 713.13 (1) (b), Florida Statutes. Expiration date of notice of
commencement is one year from the date of recording unless a different date is specified. WARNING TO OWNER:
ANY PAYMENTS MADE BY THE OWNER AFTER THE EXPIRATION OF THE NOTICE OF COMMENCEMENT ARE CONSIDERED UAPROPER
PAYMENTS UNDER CH.713.13, F.S., AND CAN RESULT IN YOUR PAYING TWICE FOR DAPROVEMENT5 TO YOUR PROPERTY. A NOTICE OF
COMMENCEMENT 1% UST BE RECORDED AND POSTED ON THE JOB SITE BEFORE IIE F ST' INSPECTION. IF YOU INTENT) 1 O OBTAIN
IINANCENG. CONSULT WITH YOUR LENDER OR AN ATTORNEY�EFORE CONI E CIN WORit OR RECORDING YOUR NOTICE OF
COMMENCMENT.
--- ���
Owner vv, Lily/ n-arcnertrvianagertSignature
Signatory's Title/Otiiee - --
r
State of Florida, County ofe
Acknowledged before mthis day of vi 20�, by Harold Salkin
who is personal] known to me or r ho has produced
as identification.
3 gnature of Notary Type or Pri t Name of Notary
;i Tlluo
Title: Vota P •:A'�";V
:*1 MYCC�iNu1SSlON#GCx34�57 s
ry Public Commission Number (yG� rj p EXvim�pIRE Odober31,2022
RP"
Ndary FUM Unda w item
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
structure. Pleasie consult withpyoiurHome Owners Association sand review your deebylaws or d for any restrictions covenants that which may astrict orl. prohibit such
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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County andosted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an9ttornev before commencing work or recording your Notice of Commencement.
Sign 't re of Own r/ e ee/Contractor as Agent for Owner I Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF -51 COUNTY OF
Sworn to (or affirmed) and subscribed before me of
9 Physical Presence or Online Notarization
thi,k� day of 2020 by
�I G Y%3 7sG
Name of person making statement.
Personally Known Ck OR Produced Identification
Type of Identification
Produced
ure of Notary
Commission No.
REVIEWS I FRONT
COUNTER
DATE
RECEIVED
DATE
COMPLETED
ev, r
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of , 2020 by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
OT riMOWD.ERICK" (Signature of Notary Public- State of Florida )
my COMMISSION 0 GG MW
OPIRSOV000ba31,2022 Commission No. (Seal)
Bor" Rn Notary Pok Mftw "
ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
�,
SU���by
Applicable
App
MORTGAGE COMPANY: Not Applicable
DESIGNER/ENGINEER:
A—
Name:
Name:
Address:
State:
Address:
State:
City:
City:
Zip: Phone:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Not Applicable
BONDING COMPANY: Not Applicable
Name:
Name:
Address:
Address:
City:
City:Zip:
Zip: Phone:
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
structure. Pleasie consult withpyoiurHome Owners Association sand review your deebylaws or d for any restrictions covenants that which may astrict orl. prohibit such
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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County andosted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an9ttornev before commencing work or recording your Notice of Commencement.
Sign 't re of Own r/ e ee/Contractor as Agent for Owner I Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF -51 COUNTY OF
Sworn to (or affirmed) and subscribed before me of
9 Physical Presence or Online Notarization
thi,k� day of 2020 by
�I G Y%3 7sG
Name of person making statement.
Personally Known Ck OR Produced Identification
Type of Identification
Produced
ure of Notary
Commission No.
REVIEWS I FRONT
COUNTER
DATE
RECEIVED
DATE
COMPLETED
ev, r
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of , 2020 by
Name of person making statement.
Personally Known OR Produced Identification
Type of Identification
Produced
OT riMOWD.ERICK" (Signature of Notary Public- State of Florida )
my COMMISSION 0 GG MW
OPIRSOV000ba31,2022 Commission No. (Seal)
Bor" Rn Notary Pok Mftw "
ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW