HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12-21-2020 Permit Number: 0
I��n n��� /�aunoo afBUI W
l�.l � ;uauapedad 6uiaaiu�aad
• »;7�
Building Permit Application 03AI ald
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: Remodel
PROPOSED.IMPROVEMENT L(oCATION:
Address: 9500 S. Ocean Dr Unit 1201 Jensen Beach FL 34957
Property Tax ID #: 4502-602-0105-000-7
Site Plan Name: Islandia II Condominium
Project Name: Talavera
New Electrical Meter Second Electrical Meter
CONSTRUC:T,ION INFORMATION
.S
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping —Shutters
KElectric KPIumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: 1550 Sq. Ft. of First Floor:
Cost of Construction: $ 47,000.00 Utilities: _ Sewer _ Septic Building Height: 200
Lot No.
Block No.
Windows/Doors _ Pond
Roof Pitch
OWNER/LESSEE
CONTRACTOR
Name Jose and Aicmee Talavera
Name: Robert Helmsorig
Address: 9500 S. Ocean Dr Unit 1201
Company: Renovation Technologies
City: Jensen Beach State: F4-
Address: 21569 Battery Park Terrace
Zip Code: 34957 Fax:
City: Boca Raton State: FL
Phone No. 305-803-8886
Zip Code: 33428 Fax:
E-Mail: amykiddo@yahoo.com
Phone No 954-632-0698
Fill in fee simple Title Holder on next page ( if different
E-Mail RENOVATIONTECHINC@YAHOO.COM
from the Owner listed above)
State or County License CGC1522634
It 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: x— Not Applicable
MORTGAGE COMPANY: x Not Applicable
Name:
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: x Not Applicable
BONDING COMPANY: x 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 attornev before commencine work or recordine vour Notice of Commencement.
Xk-7rga,"64
91w,"f W-9V-//_Xg/
�'
Signature of Owner/ essee/Contractor as A t for Owner
ignature of Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF STLUCIE
COUNTY OF STLUCIE
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 TI day of DECEMBER 2020 by
this 21 day of DECEMBER
2020 by
ROBERT HELMSORIG
ROBERT HELMSORIG
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
Signature of Notary Public- i<�aoricl� AL AM NA A
(Signature of Notary Public-
iorij 4 public . State of Florida
_ • �: Noti Public . State of Florida
,�,
LL�, g Commission. fi HH 028442
COmmIS510n NO. `'�i�d
`= Commission S HH 028442
my( Aug 5, 2024
h(vl�n, Expires Aug 5, 2024
Commission No.
�� )Expires
NZ O Z Boned through Natlbra:,N-otary Assn.e2
through National Notary Assn.
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE_
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/ U/ Lu