HomeMy WebLinkAboutPermit ApAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3/29/2021
Permit Number:
S CM �
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial X Residential
2300 Virginia Avenue, Fart Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Address: 9650 S Ocean Dr #510 Jensen Beach, FL 34957
Property Tax ID #: 4502-610-0050-000-1
Site Plan Name:
Project Name: MURRAY
Sliding glass door replacement, size for size - 6 SGD's, FPA#: 12519.4, 12519.2
Thomas Murray
Robert Cornetts
Lot No.
Block No.
Address: 9650 S Ocean Blvd #510 Company: Coastal Green Energy Solutions
City: Jensen Beach State: _ Address: 6710 Benjamin Rd #200
Zip Code: 34957
City: Tampa
Phone Nc.516-375-4518 Zip Cade: 33634 Fax:
E-Mail: civilmet@aol.com Phone No 813-512-6014
State: FL
Fill in
State: FL
Fill in
fee
simple
Title Holder on next page (if different
E-Mail Permitting@coastalgreenenergy.com
from
the
Owner
listed above)
State or County License CGC1523579
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.
INEER: Not Applicable I MORTGAGE COMPANY: _ Not Applicable
Name:_
Address
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
Name:
Address:
City: State:
Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:_
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 our Notice of Commencement.
Signature of ner/ Lessee/Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF StLucia
CO U NTY OF s, Lucia
Sworn to (or affirmed) and subscribed before me of
worn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
Physical Presence or Online Notarization
this'Lc�\ydayof t% uwccV, ,202� by
this 20��dayof 1" --(A _ ,202$ by
Thomas Murray
Rabert Cometta
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 wZ.y%S \�CP'C�f �.
Produced 9
sP,
(Signature of Notary Public- State of orida
5 natAire of Notar Public- State f Flor' � s5 oe Jc
�-VN�S �pN 31'�tiAcx
t
Commission No. (Se SOe2p°��°
Commission No. •• e,;�„,(S a
., Tor .Otc:
REVIEWS
FRONT;
SUPERVISOR
PLANS
VEGETATION
SE
MANGROVE
COUNTER
,•;
REVIEW
REVIEW
REVIEW
RE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/aj2u