HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
S�To IUC R
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 10600 S. Ocean Drive #501, Jensen Beach, FL 34957
Property Tax ID #: 4511-517-0048-000-6
Site Plan Name:
Project Name: Kokenos
DETAILED DESCRIPTION OF WORK:
Install 2 Impact SGD's
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 _ Windows/Doors
Electric _ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: _
Cost of Construction: $ 9400.00
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic
Lot No._
Block No.
Building Height:
Pond
Pitch
OWN ER/LESSEE:
CONTRACTOR:
Name Pericles Kokenos
Name: John Zervopoulos
Address: 10600 S Ocean Drive #501
Company: Advanced Hurricane Protection
City, Jensen Beach State: _
Zip Code: 34957 Fax:
Phone No. 203-615-1655
Address: 4517 SE Commerce Ave
City: Stuart State: FL
Zip Code: 34997 Fax:
Phone No 772-220-1200
E-Mail:
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail John@advancedhurricane.net
State or County License CBC1259339
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: Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
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.
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 cornmencine work or recordiniz vour Notice of CDmZencement.
Si ature of r/ Lessee/Contractor as Agent for Owner
S' ature ntractor/License Holder
O FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF YY)
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
P�ysical Presence or Online Notarization
Physical Presence or Online Notarization
this _gT day of M C&�.A , 202$ by
this day of r , 202V by
Name of person making state ent.
Name of person making statement.
Personally Known ,. OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Ell
Produced
mz ,7aJ i
(Signatur4 of Notary Pu6lic- State of Florida)
[Signature of Notary Public- State of Florida )
Notary P�b tote of Fkonda
Commission No. "` %gat
Commission No. a
Nleiiss t
_ My Commission GG 133395
a J'y PU bic state of orsda
EwoldtMye
Expues OBno12021A
;NMot;.J'i]ryP
8i1Q12021REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGE
OVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
EVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 5/b/ZU