HomeMy WebLinkAboutPermit ApAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial X Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772) 462-1S78
Address: 9650 S. Ocean Drive, Unit 1908, Jensen Beach, FL 34957
PropertyIaxID #: 4502-610-0178-000-4
Site Plan Name:
Project Name: Michael and Kimberly Mars
Lot No.
Block No,
window replacement and door replacement, size for size, 4 windows and 2 sliding glass doors, FPA's 8153.2, 14590.1, 12519.2, 12519.4
New Electrical Meter Second Electrical Meter
Additional work to be
performed under
this permit— check
all that apply:
_Mechanical
_ Gas Tank
_ Gas Piping
_ Shutters
Electric _Plumbing
Total Sq. Ft of Construction: 1346
Cost of Construction: $ 21552.00
_Sprinklers _Generator
_Windows/Doors _Pond
Roof Pitch
Sq. Ft. of First Floor:
Utilities: Building Height:
_Sewer _Septic
Name Michael and Kimberly Mars
Address: 9650 S. Ocean Drive, Unit 1908
City: Jensen Beach, FL State: _
Zip Code: 34957 Fax:
Phone No.618-267-7493
E-Mail: mmkm514@gmail.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
Name: Robert Cornetts
Company:Coastal Green Energy Solutions
Address: 6710 Benjamin Road, Ste, 200
City: Tampa State: FL
Zip Code: 33634 Fax:
Phone No813-512-6014
E-Mail Permitting@coastalgreenenergy.com
State or County License CGC1 523579
Name: Robert Cornetts
Company:Coastal Green Energy Solutions
Address: 6710 Benjamin Road, Ste, 200
City: Tampa State: FL
Zip Code: 33634 Fax:
Phone No813-512-6014
E-Mail Permitting@coastalgreenenergy.com
State or County License CGC1 523579
is required.
SUPPLEMENTAL`COIUSTRUGTI;OIV,LFEN LE(Vsf`fNFfIR
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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 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 or an attorney before commencing work or recording`yourNoticeof Commencement.
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Signature of Ow er/ LeAeti/lQfrrractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF St \
COUNTY OF S\
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
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