HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3 3i zl Permit Number: 7' "
REC€
MAR 31 1011
Cpermitting DzPa
Building Permit Application St.Luelew0,
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)462-1578
PERMIT APPLICATION FOR:install impact window
PROPOSED IMPROVEMENT LOCATION:
Address: 10410 S Ocean Dr Unit 302 Jensen Beach, FL 34957 '
Property Tax ID#: 4511-514-0011-000-9 Lot No.
Site Plan Name: Block No.
Project Name: Hutchinson Island Club
DETAILED DESCRIPTION OF WORK:
Replace existing window with impact window ➢
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
—Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction:$ 2400.00 Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE CONTRACTOR:
Name Don&Robin Stacks Name:Thomas Flynn
Address:10410 S Ocean Dr Unit 302 Company:The W Group, Inc
City: Jensen Beach State:_ Address:1409 SW Albatross Way
Zip Code: 34957 Fax: City: Palm City State:FL
Phone No.786-457-4710 Zip Code: 34952 Fax:
E-Mail:dstacks@aol.com Phone N0772-220-1930
Fill in fee simple Title Holder on next page(if different E-Mailtomflynn@twgcontractors.com
from the Ownefl-1sTed-above)______._ State or County License CGC1505177
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 MORTGAGE COMPANY: _Not Applicable
N a m e:CSM Engineering,LLC Name
Address:208 Sw Ocean Blvd Address:
City: Swart State: FL City: State:
Zip: 34994 Phonen2-22o-460, Zip: Phone:
FEE SIMPLE TITLEHOLDER: _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 our Notice of Commencement.
Sign a of Owner/Lessee/Contractor as Agent for Owner Signatu ntractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OFStLuoie COUNTY OFStLucie
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
x Physical Presence or Online Notarization x Physical Presence or Online Notarization
this 27 day of March 2020 by this 27 day of March ,2020 by
Thomas J Flynn
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
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( re of Notary Public-State of Florida) qsigature of Notary Public-State of Florida)
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