HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR'APPLICATION TO BE ACCEPTED �/�
Date: Permit Number: CW10,' 1)S9.3
- - _ Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Residential X
PERMIT TYPE:
PROPOSED IMPROVEMENT LOCATION';
Address: 10725 S. Ocean Drive 40, Jensen Beach, FL 34957
Property Tax ID #: 4511-501-0211-000-11 Lot No.1
Site Plan Name: Block No. G
Project Name:
R harlmnm 7 hath twn ctnni all imnnrt
CONSTRUCTION INFORMATIQN1.
AdditiAnal work to be performed under this permit— check all that apply:
�(Mechanical _Gas Tank _ Gas Piping _ Shutters V Windows/Doors
t//
Electric V Plumbing _ Sprinklers _ Generator Roof Pitch
Total Sq. Ft of Construction: % Sq. Ft. of First Floor:
Cost of Construction: $ _ Utilities: —Sewer _Septic Building'�Height:
,,OWNER LESSEE
CONTRACTOR
Name Steven C. Smith and Andrew W. Smith
Name: James Newman
Address: 360 W. Wellington Avenue
Company: JWN Builders LLC
Address: 1701 SE Carvalho Street
City: Chicago State: _
Zip Code: 60066557 Fax:
Phone No. J7,L29 'cam/7d �� }��
City: Port St. Lucie State: FL
Zip Code: 34983 Fax: 772-871-9500
E-Mail:
Phone No 772-871-9500
Fill in fee simple Title Holder on next page (if different
E-Mail jwnconstruction@comcast.net
from the Owner listed above)
State or County License 1328282
If value of construction is $2500 or more, al RECORDED Notice of Commencement is required.
If value of HVAC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CQN$TRUCTI OWUEN LAW INFORMATION
. ,GIN 'E _.
DESIGNER/ R:
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address: / ¢
Or
Address:
City:�yJre�iv�lGP,i�f
State:
City: State:
Zip: Phone2Z2—,�25°SI—�Z/(p
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 YQU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN -ATTORNEY BEFORE RECORDING YOUMNOTICE OF COMMENCEMENT:'
i
Sig a of Owner/ Lessee/Contractor as Agent for Owner
SignZCof Contractor/License Holder
STATE OF FLORIDA
STAF FLORIDA
COUNTY OFsT.LUCIE
COUNTY OFsT.LUCIE
The forgoing instrument was acknowledged before me
�e.�.
The for oing instrum nt was acknowledged before me
day 24i by
this day of ; , 20 by
this of
Name of person making statement.
Name of person making statem
Personally Known 1�1_/OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
JAI I
(Signature
(Signa •ria`o a - f Florida )
,�;�e:'•, SHARON K. NEWMAN
:,; mm salon GG 094675
ExplresApril20,
Commissio
j4p. :.__ Commission#GoM671)Seal)
Commis 2021
Af Expires April 20, 2021
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P,ie°-' Bonded Thru Troy Fain Inaurenca,800.386_7019
REVIEWS
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SUPERVISOR
PLANS
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COUNTER
REVIEW,
REVIEW
REVIEW,
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE'
COMPLETED
Rev. 2/7/19