HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 6/28/21 Permit Number:
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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 FORMindow Replacement
PROPOSED IMPROVEMENT LOCATION:
Address: 10410 S Ocean Dr Unit 1109 Jensen Beach, FL 34957
Property Tax ID #: 4511-514-0092-000-0 Lot No._
Site Plan Name: Block No.
Project Name: Hutchinson Island Club
DETAILED DESCRIPTION OF WORK:
Replace with impact resistant window.
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 _ Pond
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 2300.00 Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name PC; c Cva ze
Address: (0410 S Oct'-PH2 Ali; 1
Name:Thomas J Flynn
Company:The W Group, Inc
1409 SW Albatross Wa
Address: y
7
City: J t�S�ti M State: _
Zip Code: 3Yc)5 Fax:
Phone No. (,, 30 - go,!
E-Mail:
City: Palm City State: FL
Zip Code: 34990 Fax:
Phone N0772-220-1930
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mailtomflynn@twgcontractors.com
State or County License CGC1505177
If value of construction is 2500 or more, a RECORDED Notice oT commencement is requlrea.
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:
City: State:
Zip: Phone:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
BONDING COMPANY: Not Applicable
Name:
Address:
Address:
City:
Zip: Phone:
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 i obtain financing, consult
with lender oran attorney before commencing work or recording yo otice of Commencement.
of Owner/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY 0FStLucie
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
this 28 day of June 2020 by
Thomas J Flvnn
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
Produced[l
of Contractor/License Holder
STATE OF FLORIDA
COUNTY 0FStLucie
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
this 28 day of June , 2020 by
Name of person making statement.
Personally Known x OR Produced Identification
Type of Identification
nature of Notary P - TO CTZ 7 ' - - - - (Si�tdire'of Notary e�Je�I�46*
Notary Putt c State of Florida
'efTracy A. Price Notary Public State of Florida
Commission No. My Co (1r(%ll��n HH 085816 Commission No. Tracy A. Pr�i§�al
Expires 03/2 /2025 �— Pity Commission H 085816
a F� N� Expires 03/27/2025
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED