HomeMy WebLinkAboutBuilding Permit Application b c�ao�1 ao � 31
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:'�O(�����as
RECEIVED
MAR 12 2021
Building Permit Application Permitting Daaartment
Planning and Development Services st. Lucie Count;
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT TYPE`.W'�,,,,�. � i -bwr
PROPOSED IMPROVEMENT LOCATION:
Address: 9550 S Ocean Dr Unit 1201
Property Tax ID#: 4502-601-0105-000-4 Lot No.
Site Plan Name: Block No.
Project Name: Mrsan Residence
DETAILED DESCRIPTION OF WORK:
_L rY 57-i411 '7 O I out 5S cy i o►t,��C�9 y4 �.
LI-ItI L Cc.> sk'1r4 6�to_ s boors
[CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 7 0- 2 G 1 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Marilyn Mrsan Name:Richard A Shores
Address: 9550 S Ocean Dr-Unit 1201 Company:Folding Shutter Corporation
City: Jensen Beach State:_ Address:.1862 Dr Martin Luther King Blvd
Zip Code;'34957- Fax:n/a City: West.Paim Beach: r State:FL
Phone No.'989-366-5845 Zip Code: 334'04 Fax: 561-640-8204
E-Mail:n/a Phone No 56'1-688 4811
Fill in fee simple Title Holder on next page(if different E-Mail info@foldingshutters.com
from the Owner listed above) State or County License SCC131151222
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.
i
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: 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 YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF PALM BEACH COUNTY OF PALMBEACH
The for oing instrument w s acknowledged before me The for oing instrument wa acknowledged before me
thisdayof Max 20� by this dayof ]MVRA-c-K 20 z1 by
RICHARD A SHORES RICHARD A SHORES
Name of person making statement. Name of person making statement.
Personally Known -- OR Produced Identification Personally Known — OR Produced Identification
Type of Identification Type of Identification
Produced Produce
(Signature of Notary Public-State of Florida) (Signature of Notary Public- sate ofFFApf .Evans
.11R A Pamela A.Evans of 9s
Commission No. NOTARY PUBLIC
NOY)PUBLIC Commission No. 9� �STAT� dIORIDA
g STATE OF FLORIDA
W Comm#GG262789 Comrct#GG282789
1 Expires 0/11/2022 xp
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
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