HomeMy WebLinkAboutPermit AppAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date:
Permit Number:
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0
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential x
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMITAPPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION.
Address: 10044 S Ocean Drive Apt 906, Jensen Beach, FL 34957
Property Tax ID #: 4502-804-0070-000-2
Site Plan Name:
Project Name: Michael Perez
DETAILED DESCRIPTION OF WORK:
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
Lot No.
Block No.
Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Pond
_Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction:
Cost of Construction:
Sq. Ft. of First Floor:
Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Michael Maltman
Name: Scott Berman
Address: 10044 S Ocean Drive #906
Company: Florida Window & Door
City: Jensen Beach State: _
Zip Code: 34957 Fax:
Phone No. 772-359-7600
Address: 1125 N Dixie Highway
City: Lake Worth State: FL
Zip Code: 33460 Fax: _
Phone No 561-3404300
E-Mail: mmalt26@yahoo.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail howard@floridawindowanddoor.com
State or County License CGC1509450
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:
Name:
Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City:
Zip:
Phone
State:
City: State:
Zip: Phone:
FEE SIMPLE TITLE
Name:
HOLDER:
_ Not Applicable
BONDING COMPANY: Not Applicable
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.
Inconsideration 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 efore commencing work or recording your Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner � Signature
STATE OF FLORID
COUNTY OF �%!ii.-�
Sworn to waffirmed) and subscribed before me of
s' al Prese ce r Online Notarization
this ay of 2020 by
Michael Mailman
Name of person making statement.
Personally Known OR Produced Identification
Type of Identific/at�ion /
Prodeced �zi/T L1 I (� m L��
mature of Notary Public- St�a��Q�eclorida) JESSEDOSS
��om Isslon # GG 263069
Commission No. Ezp relg September27, 2022
��OFF�OQ� Bonded ThruBudget Notary Senkne
STATE OF FLORIDA
CO U NTY O F Palm Beach
older
Swo o (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this day of �.t �� aiemM by
2oZl
Scott Berman
Name of person making statement.
. No>'ao}
Personally Known x OR 40 N�q�
Ty f Identification a • dut d �oaw 4
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re of
Commission No.
Public- State of Florida
(Seal)
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