HomeMy WebLinkAboutGreen - Permit Application, Signed & NotarizedAll APPLICABLE INFO MUST BE C
Date: 03-25-2021
� . LUcLL
PLCILLLIA
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 3
Phone: (772) 462-1553 Fax:(772)
FOR APPLICATION TO [E ACCEPTED
Permit Number:
Building Permit Application
1578
Commercial I Residential X
PERMIT APPLICATION FOR:
REEN, STEPHE
& LALLY-GREEN, MAUREEN
PROPOSED IMPROVEMENT
[OCATION:
Address: 9600 S OCEAN DR UNIT 1
1 JENSEN BEACH FL 34957
Property Tax ID #: 4502-620-0091-0
-1
Lot No.
Site Plan Name: EMPRESS CONDOI
IINIUM UNIT 1201
Block No.
Project Name: GREEN
DETAILED DESCRIPTION OF
ORK:
Drain and remove existing 7 year old
0 gallon tall Bradford White wa
er heater on the floor in the Laundry Room.
Supply and install new 40 gallon Brad
ord White residential tall electri
water heater.
New Electrical Meter S
and Electrical Meter
CONSTRUCTION INFORMA
ON:
Additional work to be performed u
_Mechanical _Gas Tank
_Electric X Plumbing
Total Sq. Ft of Construction:
Cost of Construction: $ 945.00
ider this permit — check all th
_Gas Piping _S
_Sprinklers
Sq. Ft.
Utilities:
apply:
utters —Windows/Doors _Pond
enerator _Roof Pitch
of First Floor:
ewer _Septic Building Height:
OWNER/LESSEE: I
CONTRACTOR:
Name GREEN, STEPHEN & LALLY-Gl
Address:9600 S OCEAN DR UNIT
City: JENSEN BEACH
EEN, MAUREEN
Nam
Com
Addr
City:
Zip C
Phon
E-Mail
State
: JAMES M AGER
01
any: PLUMBING BY BISHOP
State: FL
ss: 2606 SE WILLOUGHBY BLVD
Zip Code: 34957 Fax:
Phone No.724-612-8007
E-Mall: SROSSGREEN2002@YAH
Fill in fee simple Title Holder on ni
from the Owner listed above)
STUART State: F�
de: 34994 Fax: 772-286-1412
No 772-286-5872
.COM
Kt page( if different
PLUM BINGBYBISHOP@COMCAST.NET
or County License CFC-1429566
If value of construction is 2500 or morel a RECORDED Notice of Commeement is required.
If value of HAVC is $7,S00 or more, a R ORDED Notice of Commencem nt is required.
SUPPLEMENTAL CONSTRUC
101N LIEN LAW INFORIV
ATION:
DESIGNER/ENGINEER: >
Name:
Address:
City:
Not Applicable
mOR
Name:
Addr
City:
Zip:
rGAGE COMPANY: X Not Applicable
ss:
State:
State:
Phone:
Zip: Phone
FEE SIMPLE TITLE HOLDER:
Name:
Address:
City:
Not Applicable
BON
Nam
Addr
City:
Zip:
ING COMPANY: X Not Applicable
ss:
Zip: Phone:
Phone:
OWNER/ CONTRACTOR AFFIDVI
Application is hereby made to cbtain
a permit to do the work and installation as indicated.
I certify that no work or installation has
ommenced prior to the issuance
of a permit.
St. Lucie County makes no representatic
which is in conflict with any applicable
i that is granting a permit will au
me Owners Association rules, b
horize the permit holder to build the subject structure
laws or and covenants that may restrict or prohibit such
structure. Please consult with your Ho
Owners Association and review
your deed for any restrictions which may apply.
In consideration of the granting of this r
quested permit, I do hereby agr
a that I will, in all respects, perform the work
in accordance with the approved plans,
he Florida Building Codes and St.
Lucie County Amendments.
The following building permit applicatio
s are exempt from undergoing
n concurrency review: room additions,
accessory structures, swimming pools,
ores, walls, signs, screen roomd
accessory uses to another non-residential use
WARNING TO OWNER: Your failu
to Record a Notice of Comncement
may result in paying twice for
fe
improvements to your prope
. A Notice of Commencent
must be recorded in the public re�ccords of St.
Lucie County and posted o
e jobsite before the first iection.
If you in btai ttncing, consult
with lender or a v be
re commencinit work or
ordinll �yonr�+l ce o Co encement.
Owner I Sienalure of
STATE OF FLORIDA
COUNTY OF MARTIN
Sworn to (or affirmed) and subscribed )efore me of
x Physical Presence or_Onli Notarization
this 25 day of MARCH 7 021 by
DAMES M AGER
Name of person making statement.
Personally K X OR Produc d Identification
Type of Id _ on
Notary Public -
Commission No. GG 985230
OF FLORIDA
rY OF MARTIN
Swor to (or affirmed) and subscribed before me of
X f hysical Presence or Online Notarization
this -12L day of MARCH :2021 by
AGER
f person making statement.
x OR Produced Identification
Of
16,20241 C044ission No. GG985230
) LUCINE KHATCHERNN
MY COMMISSION B GG 96$
,PAD(PIRES:May 16, 2024
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