HomeMy WebLinkAboutsmallpdf - 31 Aug 2020 - 1258210
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FLOOR PLAN
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z4 PIAntting do Development Sery Ices DrpartmcnI
BuIIdirig & Cock Regulations
M Vtrfffnlr AieKue
Fort ?krc*, w tuPtQ4 349BI
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i1WNERJBU1LDER AFF]DAVIT DISC€.OSU1rRE STATE MENT
F.S. 489.103 (7) EXEMPTIONS
S
`ante lam- requires cortortw1ion to be done by licensed contractors- Yott havc npplicd fnr a permit tinder an
CxCoViion to thal lave. The exemption allows you. as the owner ol'your pnrrperty, Low as your own contractor evert
though yoo clu no] have a huense- You must provide direel, on -site supervision of the construction youra.elr You
may build or improve tarn, outbuildings, a one -family -or two-family residence for }our use and occupancy. You
may alio build or tinprovc a curntnercial building at a cost not exceeding S7S.(W.00 as long ns it is l`or your own
use or oo upancy. You imay not build or improve xaid MrKLtares tiW the purposes of selling or leasing that building.
You may nut hnre an unli�,"Wd person 10 ntrI nx your con"etor or to supervise M ple working on your building: h
is vatw rerpun;ibRity to make sure that people employed by you have liccnsys required by stoic law and by cX FTLY
or nnuuic4vi licensing ordinarxes-
ltMltial here.
If you soli or Icaw a hudding you have built or 1mpmvcd within one year after conmruction is coinpltit - -'t �� a
prounipnion iscrc.aWd that it was buih or improvod forsale of lease, which is a violatian of thiseumption,
inittni Tier
You may not delegate the Tespousibijity for supervising work to a lion xi contractor who is not licensed to perform
the work being dosre- Yoktr constructiont must comply with all applicable lazes, ordinances. building cock anti
caning regulations. Initial Here
I vnderstjnd that the building official and inspectors arc not Uteri to d ibm or give advice on hem• no nit - the
minimum Uxlc. Initial Here.
I undvrstand chat as ark amTer-builder Thai any uantrrct disputes wilb sub-conuaetors and I must be handy na civil
couct with Ike jdvicc ofan actnnxy. This dcpartrtxttt will not mitigaicany coattra'tct disputes.
initial Her .
1 ILndermand then it' I compensate any person or eompi�ny for work perfnrmad they arc mqukrad to be licensed ire this
jurisdiclion. I f for some reamnn they do not possess a Iicerwe, 1 may he responsihlc and liable for the cost if 1I70
licentsc, Initial Fier
I understand that if any peru)n that is unlicensed and mninswed gels injured on my construction project-0iq rmiy he
cntidW nu workmen's coin Cnsution, I could be held liable for all doMr. lawyer and related medical ct,s�. icic
could include loss of %-ages during rccorcry from their *wry. Initial Here.
To qualify for this cxcmption under this sub�tction, an owner must personally appear_ sign the buildin -niiil
appliealion. and ipinial tho above
I her0y ackt*wlcdgc that I havt: read and un ratan d the abuvv disclosure statement and that 1Cr;
h�Cr umlerstand
Iltat wly Violalion of the tams of the ownerrbuildcr exemption shalJSiwA
rted by tlxc I, 'rng tints Zoning
Pcpartmcnt to thu Florida Statc Mpartment of 1: mfessional LR£golatioand ac iowlad on this
day c'f.__ or2o__ ri re
STATE OF FLORIDA ,
COUNTY Of �
fhc rr g{sin - in�strurn : u K aeknuwlufgtXl beiorc nnc this day of . 20 M .
by a who is 1wrwrnatly knimn
to Irie- or xlxc has
TW17iYp.ERICKSLiH
' �Dc p4r31.2U22
n;ittlrC a Notuy Ype or Print Mune o`Nowry
+
B`�t�� PG�iC Lbi4r+�x#
Tille: Evot�ry Nblsc Comr6ssion Number
UPPLEMENTALCONSTRUCTION LIEN LAW Ih4�� RmAT'aD :' ���`r •.4,-r
DESIGh1ER Eh1C,INEEFi; fiat Applicable MORTGAGE COMPANY: Not Applicable
Name- -- Name;
Address; - Addre55:
City: State: _ City —State: --
Zip: _ Phone zip: Phone:
FEE SIMPLE TITLE HOLDER: lot Applicable
Narne;
Address:
City:
' zip: Phone:
BONDING COMPANY:
Name:
Address:
City:
Zip: Phone:
Not Applicable
OWNER/ COr4TRACTOR AFIFIDVIT: Application is hereby made to obtain a permit to do the work and Installation as indicatec!.
I certify that no work or installation has commenced prior to the issuance pf d permit-
St- Lu€ie Cpur3ty makes no representation that is granting a permit will authorize the perrnit holder to build the subject structure
which is in conilrct with any applicable Hoare Owners Association rules, bylaws or and covertarrts 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 d0 hereby agree that I will, in all respects, perform the worm
in accordance with the approved plans, the Florida Building Codes and St. Lucie CountyAmend ments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, wallsr Signs, screen rooms and accessory uses to another lion -residential use
WARNING, TO OWNER: Your failure to Record a Notre of Comm ence rne nt 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 an posted an the jobsite before the first inspection. If you intend to obtain financing, consult
v!+i iender or an11ttorney before commencing work or recording our Notice of Commencement=
5fgrot$re of
attar as Agent for Owner
STATE OF FLORIDA
COUNTY OF 75t rM c-.-- _ + r}
Sworn to (or affirmed) and sulscribed before me of
--- Physical Presence or Online Notarization
th► day of 2020 by
Name of person making statement.
Personally Known +X OR Produced Identification
Type of identification
Produced
{signature of notary P b�e
Commission r,Ia. s '•r ETWAm:bter9t,202
�.. _ �*.�' tiar�er rnv w�nr Pr�IcSYiis
REVIEWS FRONT ZONING SUPERVISOR
COUNTER REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Signature of Contractor/License Holder
STATE OF FLORIDA
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Physical Presence ar Online Notarization
this day of _ - . 2020 by
Name of person making statement.
Personally Known OR Produced Identificaiion
Type of Identification
Produced
(Signature of Notary Public- State of Florida )
Commission No. (Seal)
REVIEW RFV VEGETATI EWON S EA REVEWLE I MANG ROVE
EVI W
Permit No. Property Tax M No. 4502-610-0093-0014
State of Florid!. Corms of St. Lucie
The Undersigned hrrtl>. gives notice dint imp rovemelnt will br made to certain real prop►-riy, tend in nccordunce ► ith
Chapter 713, Florida Statutes, the foilovsing information is pros ided in this Notice of Commencement.
Legal Deseription of property and address if availllhle 9650 South Ocean Drive #1003 Jensen Beach Fl 34957
The Princess of Hutchinson Island. Unit N 1003
(kneral descripfiion of improvements RenovatierWitchen
Ovi merlrswe Harold SaWn
Addmx %50 SOUM Ocean drive #1003 Jensen Beach Fl 34957
!>likrreslt in t►ropert}�: Corner ---� -- _
Fe4 Simple Titic holder (itathi`r than owner)
Addre.r,x
C'ontraclor Owner Builder Phone # Gacorp bel lsouth.net
Address Fa1< 0
Surety
A"r4
_ Amount of Bond
Under --
,lddrexs
Phone #
Fax #
Phone Is
Fax #
Person s %v it hi n the Stu to or Florida designated by Ow ner upon whom notices or other duc u ments xnRy he ser vW as provided
b}' Section 713.13 {al T., Florida StrAues:
N:Irpe. Harold Salkin Phone # 56' 714 8847
Address 965a South Ocean Drive 01003 Jensen Beach Fl 34957 Fax #
In additHwn to hinnelr, on ncr dexigaales
phoue # Fax #
to receive it vopy of( he Lienor's Native as provided in Section 713.13 (1) ibb Florid# Statutes. Expiradoo date of notice of
commenrein4nt is env year fruin the date of rccarding unless a different date is specirsed. WARN SG TO ON►NM
A14V i,AYMLNTs MADE M' T14[_ UWNFR AI71:R Till: rxPiRATxiN 4 PF nm Noiti;E of ARf: [ ONIMDEREV IMPROPE�.R
VA1`tt1: IN l:N[11=R (-11.71 = t 1, 1:.5„ AND CAN RESULT Lh Yc Uk PIAYV%G TwIVI: I -OR IMPROVE Mk'\-P, TO YDUR PROPERTY. A NOTICE Dr'
CAVM►tFN['IMPN'T\tt.STW.RFC[ittDLI)ANDPos,rxnoNTnEJOB$ITEBFF(M IIF STIMWIE:7ION.Ii`1'W-WTE'NI)10OUTAM
irNiAI+iCING, CONSULT "r1li YOUR LENDER UR AN AfT RNEY F'MRt: COO F CIN 14'ORK OR REICT1kUrNG YOUR NOTWE 01
COMMI:N NE'NT.
Owperil,et ee.orQh 6to ar IA44ct's Aiahnrired Offierr.-FArreEel r.hkrrn:r 11nnmKvr S-iWnxrare
Owner
Signato-tY'9i TiftE Mim - — - — - —
Stitt of Florida, County 11'
Acknowledged before me this , d;N or tie 2U
m4,hroh 11rr h pierrtenall knnw�n tos prod
`'�l�i hIu�,fstory Type or Pri t !dame of Natury
I itlr. \1rvarr PIa#lie Commission Number
Harold Salkitl
as Id nfificatiOn.
MY OUMLI84" !Cif,# Z+ W
EXMFft Ober 31, i
BMW Thu %X" Nblt lMMW~
SUPPLEMENTAL LIEN LAIN INFORMATION:
DE51GNERf ENGJNEER: --- _ _ Not Applicable
Name.
Address- --
City: State: zip: Phone.
I FEE SIMPLE TITLE HOLDER: Not Applicable
Name;
jAddress:
City:
Zip: Phone:
MORTGAGE COMPANY -
blot Applicaoio -
Name:
Address:
City: Y State:
Zip: Phone-,
BONDING COMPANY- 'Not Applicable
Name:
Add rest.:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDIIIT: Appl€cation is hereby made to obtain a permit to do the work and iestaliatiort as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St- Lucie County makes no representation thar is gra rating a permit wil I authorize the permit In of der to build the su bject structu re
whkh ,is In conflict with any appiiezMe Horne Gw�+ers Association rules. bylaws or and covenants that may restrict or prahittat such
:!rurlure. Please consult wrath your Home Owners Associatlan and review your deed for any restrictions which may dppiy.
Irr consideration of the granting of this requested permi41 do hereby agree that I will, in all respects, perform the work
in accordance vrith the approved ptans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applicatlons aru exempt From undergoing a full concurrercy review: roam additions,
accessory Strutxures, swi mining pools, fences, walls, signs, screen rooms and accessory rises to another non -re sidentia' 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 posted An the jobs ite before the first Inspection. If you intend to obtain financing, consult
with lelider or an attorn#V before commencing work or recordiniz your Notice of Commencement.
as Agent for OWr]$r
STATE OF FLORI
COUNTY OF �•L tA 1A oL
S orn to (nr affirmed) and subscribed t ForB one of
Physlraf PreseT1cc or Online Notarization
this day of 24 0 by
i Name of person making statement.
Personally (nown 9_ OR Produced ideniRication _T
Type of Identi#ica#on
Produced — —
i
(Signature o.` Notary P
Commission No.
k
" ' 'T1pf0CtiY Q. ERICMS M
Uy C3MML% 10H # C_G 234W
tam er 214. =
&4k W nit .day #built 0VV_kn
REV$EWS FRON'l I ZONING
WUNTER REVIF*
{SATE �
i RECEIVED
DATE
COMPLETED
KPv. -
Signature of Ontractodticense Holder
STATE OF FLORIDA
COUNTY OF
Swom to (or affirmed) and subscribed before me of
Physical Presence or Online Notarizatior
this day of .200 by
Name of person making statement,
Personal ly Known _ _ OR Produced ttlentification
Type of identification
Produced_-__....
(Signature of Notary Pubflc- State of Florida )
Commr svan No. (Seaq
SUPERVISOR I PLANS I VEGETATION I SEA TURTLE= i MANGROVE
REVIEW REVIEW REVIEW J REVIEW RIME
Al APPLICABLE INFO MUST BE C0MPLETED FOR APPLICATION TO BE ACCEPTED
[?ate= August 24,2020 Permit Number: ��
,� 4 L- uz
Building Permit Application
Planning and f evefoprnent 5ervrtes
Budding anaCode equiarlonDivisi Commercial x Residential
23W Virginia Avenue, Fax Pferce Ft 34W
Phone: (772) 462-1553 Fax- (7721462-1578
Pr. RM IT APPLICATI ON FOR: F enovation
PROPOSED UPROVE EIV;f`OCAI -- Y
Address: 9650 S oulh Ocean Drive # 1003. Jensen Beach, Florida 34957
Property Tax ID M 4502-610-909 -Obf4
Site Plan Name,
Project name;
DE TAILED DESCRIPTION OF WOR :
Lot
Mock No:
Rennvate KitMen, Now Cabinets. All Plumbing to remain in same Ior: alian.Clectrtc access !a remain in saTT3r, loaauon #or �E
12 jolt overhead lighting, Arc Flash C FOI breakers installs& replaced in Panel for Kitchen.
New Electrical Meter Second Electrical Meter
LON.5".iUCTION INFORMATION:
;dd tiQFJal work to be p'erforrned under this permit —check all that a I
pp y, !
Mechanical
Electric
Gas Tank
— Plumbing
Total Sq. Ft of Cons tracbon : 126
rust of Construction: 19,600,00
Nar"e.Harold $alkin
Gas Piping
Sprinklers
— Shutters — Windows/Doors
Generator Roof
Sq: Ft: of First Floor.
Utilities: _Sewer _Septic Building Meight:
Address:9650 South Ocean Drive # 1003
Jo~+ erg Beach i=lo .4 —
Name:
Company: _
Pond
Pitch
City: k I a State: Address:
Zip Code: 349 ST Fax: City: _-- State:
Phone No.561 714 8847� — . Zip Cade: Fax-
F w.aii; CA 8corp@bellsouth.net
Phone No --
Fill in fee simple Title Holder on next page ( if different r E-Mail—
from the Owner listed above) I State or County Llcense
•f Val L4e of construct€on is 2500 or more, a RECORDED Notice of Commencement Is rrxquired.
It value of HA11C is S7,500 or were, a RECORDED Notke of Commencemerd Is required.