HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED i�•� Q 1
Date: 6I10 it PermitNumber:R/0�-lJoc,.O1
Building Permit Application
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: wi t>ow R�-PLAI-�OMelr�
PROPOSED IMPROVEMENT LOCATION:
Address: 10410 S Ocean Dr Unit 604 Jensen Beach, FL 34957
Property Tax ID #: 4511-514-0040-000-1 Lot No.
Site Plan Name:
Project Name: Hutchinson Island Club
DETAILED DESCRIPTION OF WORK:.
Replace one window with impact
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank —Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction:
Cost of Construction: $ 2400
_ Generator
Block No.
_ Windows/Doors _ Pond
Sq. Ft. of First Floor:
Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNERAESSEE:
CONTRACTOR:
Name COIZDFi_iA MA"<
Name:
Address: 10'i h S O&EA0 D2 ('0`i
Company:
City: 0-Gly Go Bowl State:
Address:
Zip Code: 3'(g � 7 Fax:
City: State:
Phone No. 772 - 45 - 2tg7
Zip Code: Fax:
E-Mail:
Phone No
Fill in fee simple Title Holder on next page ( if different
E-Mail
from the Owner listed above)
State or County License
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC Is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
NER/ENGINEER: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with an applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult w/ th your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend t in financing, consult
with lender or an attorney before commencing work or recordir gy4$jr Not' o Commencement.
as Agent for Owner
STATE OF FLORIDA
COUNTY OFS«ucia
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
this 21 day of May , 2020 by
Thomas J Flynn
Name of person making statement.
Hol
STATE OF FLORIDA
COUNTY OFStLucle
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
this 21 day of May 2020 by
Thomas J Flynn
Name of person making statement.
Personally Known x
OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Id e tification
Produced A
Produced
u e of Nota
p;pr;�
ture of Notary Pu
racy A. Price
�� M PK+ Notary Public State of Florida
Commission No.
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Commission No.
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o► ,e- Expires 03/27/2025
REVIEWS FRONT ZONING SUPERVISOR
PLANS VEGETATION
SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW
REVIEW REVIEW
REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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