HomeMy WebLinkAboutbuilding permitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: March 4, 2021 Permit Number:
Building Permit Application
Planning and Development services
Building and Code Regulation Division Commercial Residential x
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:Renovation of Kitchen, Laundry, Mud Room, Misc.
PROPOSED IMPROVEMENT LOCATION:10840 Kimberfyld no, Port St. Lucie, FL 34986
....... 10840 Kimberfyld Lane, Port St. Lucie, FL 34986
Property Tax ID u: 3321-501-0020-000-9 Lot No.
Site Plan Name: Block No.
Project Name: Interior Alterations at: 10840 Kimberfyld Lane, Port St. Lucie, FL 34986
I DETAILED DESCRIPTION OF WORK:
room,
new
appliances, electrical, plumbing, hvac, drywall, flooring, painting, and amenities
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
✓Mechanical _Gas Tank ✓Gas Piping _Shutters ✓Windows/Doors _Pond
Z Electric r[Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: 967
Cost of Construction: $ 90,000.00
Sq. Ft. of First Floor: 3430
Utilities: _Sewer ZSeptic Building Height: 30
OWNER/LESSEE:
CONTRACTOR:
Name B - L
Name:
—CONSTRUCTION
Addre,,'P BOX 121031
Company:JANSSE CORP.
City: SAN DIEL30State: CA
Zip Code: 92112 Fax:
Phone No.61�-7a2-U3-40—
Address: 1
City:RIBEACH State:
Zip Code: 3 Fax: 561.203.2441
Phone No 8.42
E-Mail: FL
Fill in fee simple Title Holder on next page ( If different
from the Owner listed above)
E-Mail BJA EN@J SENCONSTRUCTION
State or County License B 4 857
It value of construction Is 2Sw or more, a KtLVH V CV norxe or commencemen%,a requneu.
if value of HAVC Is $7,500 or more, a RECORDED Notice of Commencement is required.
PPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable
Name: DAILEY JANSSEN ARCHITECTS, PA.
MORTGAGE COMPANY:
Name:
x Not Applicable
Address: 400 CLEMATIS STREET, SUITE 200
Address:
City: WEST PALM BEACHState:_
Zip: Phone
City:
Zip: Phone:
State:_
FEE SIMPLE TITLE HOLDER: x Not Applicable
Name:
BONDING COMPANY:
Name:
X Not Applicable
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 ermit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or anScovenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
Inconsideration 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
with lender nr an attnrnev before enmmencine work or recondite vour Notice of Commencement.
Signature of Owner/ L e /Contractor as Agent for Owner
Signature of Cdqtra or/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF PALM BEACH
COUNTY OFPALM BEACH
Sworn to for affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
xTMysical Presseence r Online Notarization
x PresenceorOnline Notarization
this _ day of 2020 by
SPhysical
this _day Of 2020 by
BENNO JANSSEN, III
BENNO JANSSEN, III
Name of person making statement.
Name of person making statement.
Personally Known X OR Produced Identification _
Personally Known X OR Produced Identification_
Type of Identification
Type of Identification
Produced
Produced
1.
(Signature o Notary Public- State of Flor Ea.
"S' ture o Notary Public- State
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