HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED CqQ .b" }� )
Date: Permit Number: U'
llo L-l`y 1�Q� AECEIVEp
Building Permit Application a�R 2 2011
Planning and Development Services
Building and Code Regulation Division Commercial X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:One window replacement
PROPOSED IMPROVEMENT LOCATION:
Address: 10410 S Ocean Dr. Unit 708 Jensen Beach, FL 34957
Property Tax ID #: 4511-514-0053-000-5
Site Plan Name:
Project Name: Hutchinson Island Club
DETAILED DESCRIPTION OF WORK: ,
Replace one window with impact window
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
F9.FR1ft9 Department
Eg. Lucie County
Residential
Lot No.
Block No.
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: _
Cost of Construction: $ 2200.00
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWN ERAESSEE:
CONTRACTOR:
Name Ed Giardina.
Name:Thomas J Flynn
Address:10410 S Ocean Dr unit 708
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.617-694-2669
Zip Code: 34990 Fax:
E-Mail:eg@giardina.cc
Phone N0772-220-1930
Fill in fee simple Title Holder on next page ( if different
E-Mailtomflynn@twgcontractors.com
from the Owner listed above)
State or County License CGC1505177
IT Value Or construction is zbuu 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
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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.
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Signaatdre of Owner/ Lessee/Contractor as Agent for Owner
natur Contractor/License Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OFS«ucla
COUNTY OFSt Lucie
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 23rd day of Apr! 2020 by
this 23rd day of April . 2020 by
Thomas-J Flynn
Thomas J Flynn
Name of person making statement.
Name of person making statement.
Personally Known x OR Produced Identification
ti
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced
Produce
n r`
( nature of Notary Public- State of Florida }
ature of Notary Public- State of Florida
state of F1
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Rev. 5/6/10a�`