HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:(���
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Building Permit Application pernutt/n 22ty
Planning and Development Services St. 4 s oe
ucte co my e
Building and Code Regulation Division � nt
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT TYPE:
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R'ROPOSED I IVI�PRO,VEME�NT�LOCATION.�";�'��'�''��x
Address: 235 Nettles Blvd., Jensen Beach, FL 34957
Property Tax ID #: 4502-501-0421-000-8
Site Plan Name:
Project Name:
Add PGT impact single hung window in wood wall in rear of home
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ $3,700.00 Utilities: _ Sewer, _Septic
Lot No. 235
Block No.
_ Windows/Doors
Roof Pitch
Building Height:
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Name Guy Scott and Jennifer Rector
Name: James Newman
Address: 235 Nettles Blvd.
Company: JWN Builders LLC
City. Jensen Beach, FL State: _
Address:1701 SE Carvalho Street
City: Port St. Lucie State: FL
Zip Code: 34957 Fax:
Phone No. 954-347-3313
Zip Code: 34983 Fax: 772-871-9500
E-Mail:
Phone No 772-871-9500
Fill in fee simple Title Holder on next page ( if different
E-Mail jwnconstruction@comcast.net
from the Owner listed above)
State or County License
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.
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SUPPLEMENTAL CONSTRUCTION9LIEN LAW INF®R
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;�G::.i
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
N am e: Dale Sorensen
Name:
Address: 227 SE Pelican Drive
Address:
City: Stuart State: FL
City:
State:
Zip: 34996 Phone
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 YO NOTICE OF COMMENCEMENT."
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signat a of Co/Licens ntractore Holder
STATE OF FLORIDA
ST E OF FLORIDA
COUNTY OF ST. LUCIE
C UNTY OF ST. t.uCiE
The for oing instrumEtnt wa&J&owledged before me
this i
Iv- day of 20g by
The forgoing instrum nt wa knowledged before me
this day of 20_ by
Name of O&son making statement.
Name of person making statement.
Personally Known ✓/ OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature V
(Signatur
�er+tli
SHARON K. NEWMAN
Commission#GG094675(Sea1)
,��s�:s,, SHARON K. NEWMAN
Commission#GG094675
Commissio €Ploo '-
Commissi
;. (Seal)
, ``; xp res pril 20, 2021
. ; . P,q xplres pn , 2021
8 , Bonded Thru Troy Fain insurance 800.385.7018
''° ��� ��� BordedT►w TmyFain Insurance 800.385-7019
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
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DATE
RECEIVED
DATE
COMPLETED
Rev.2/7/19