HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 8/21/2020 Permit Number:
LIM.Eur L ELF
........... Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial X Residential
2300 Virginia Avenue, Fort Pierce FL 3498,2
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR: Emergency Repair
EPCOP&S—ED jIKP�R—YE!A�NT O LOCATION:
Address: 7420 South Ocean Drive Jensen Beach, Florida 34957
Property Tax ID#: Lot No.
Site Plan Name: Sand Dollar Shores Condominium (Building B) Block No.
Project Name: Sand Dollar Shores Condominium
DETAILED DESCRIPTION OF WORK:
7th Floor Catwalk Repairs (from 8719 to 8721)
New Electrical Meter—second Electrical Meter
CgNS ION INFORMATION:
Additional work to be performed under this permit-check all that apply:
—Mechanical —Gas flank —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: $ Utilities: _Sewer —Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name l r re" Name:Patrick Flack 11
Address:2-YJ o a"al-) 01-i P< Company:Flack's Painting Waterproofing Inc.
City: k' L- f) 1:C n 'b C.� (Z-) —StateF-(- Address: 1 00 NE 26th Ave
Zip Code: Fax: City: Pompano beach State: FL
Phone Nor._j — Fax:
2d - Zip Code: 33062
Phone No(954)786-7535
Fill in fee simple Title Holder on next page(if different E-Mail Flacksrestoration@gmaii.com
from the Owner listed above) State or County License CGC 1521737
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.
DESIGNER ENGII EER: .. Not Applicable MORTGAGE COMPANY: Not Applicable
Name: 1f r Name:
�Address., t u - , Address:
City: w l State: d= City: State:
Zip: Phone �� - 6 -1-X1 1,? 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: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 St.
Lucie County and pasted on the jobsite before the first inspection. if you intend to obtain financing, consult
with lender or n ttor before commencing work or recording your Notice of Commencement.
Slgnat are o Ow e Lessee/Conti etor as Agent for Owner Signature of Contractor/License Holder
TA E 0 'D I,DA STATE OF FLORIDA
CO N Y CIF COUNTY OF Rro ad
Swor 1 to(or affirmed)and subscribed before me of Sworn to for affirmed)and subscribed before me of
P��{{ysical Presence or Online Notarization X Physical Presence or Online Notarization
thts� "i day of V it 2020 by this 21 day of August 2020 by
0o,C S
&A4:y Patrick Flack it
Name of person making statement. Name of person making statement,
Personally Known lv' OR Produced Identification Personally Known x OR Produced Identification
Type of Identification Type of Identification
Priduced Produced
X
_ HLEY THOMPSON
(Signature of Notary .e ignature of t Puf ��
�j c mm*oion Go 23MI �,o; � S.
March 21,2024
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Commission No. " ea Commission No. ooassjc
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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RECEIVEID
DATE
COMPLETED
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