HomeMy WebLinkAboutApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: n -, a, �~ Permit Number:
T. LUCIE
C r�ry
F L O R..-.i DA,'-'`
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 7410 S OCEAN DR 205 Jensen Beach, FL 34957
Property Tax ID #: 3522-605-0006-000-1
Site Plan Name: Sand Dollar Villas Condominium D
Project Name: 9ary
DETAILED DESCRIPTION OF WORK:
furnish and install 1 white impact accordion shutter
New Electrical Meter
Second Electrical Meter
CONSTRUCTION INFORMATION:
Residential x
Lot No.
Block No.
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:
Cost of Construction: $ 700
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Gary Jackson
Name: Stephen Rosendale
Address:7410 S Ocean Drive 205
Company: East Coast Construction Co. Inc.
City: Jensen Beach State: _
Zip Code: 34957 Fax:
Phone No.305-978-0889
Address:6671 west indiantown road ste:50-342
City: Jupiter State: FL
Zip Code: 33458 Fax:
Phone No561-935-3777
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail Steve@eastcoastcompanies.com
State or County LicenseCBC1263210
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
BONDING COMPANY: _Not Applicable
Name:
Address:
Address:
City:
Zip: Phone:
City:
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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
. ;+k Ie..rler „r �n **.,rnmi hnfnra rnmmanrino wnrk nr rprnrdino your Noting-e-f"CommAncement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contr or/License Holder
STATE OF FO�`��
GR
TATE OF FL H A
COUNTY OFFC.%M
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Sworn t or affirmed) and subscribed before me of
Physical Presence or _Online Notarization
this day of 2020 by
ysicaI P Bence or _Online Notarization
this f��� 2020 by
Name of perso king statement.
Name of per n making statement.
Personally Known OR Produced Identification
Personally Known ✓ OR Produced Identification
Type of Identi
Type of Identification
Produced IPc h
Produced
BECKY ROSENDAILE(Signatur
Notary Public- *aif4NMlSSMOGG0734;2q;ign�ature
of N tary Public -State of Floridrxrrt�EXPIRES
Febnvuy 15, 2
;Maus whn�-slNe
mmission No. �-1�'i "I(O l-A
/; 145.1&d
cm, *,h
Commission No.
,'arm
„y
thmughWeml
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev.