HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED J ' 7,l 33 8'
Date: 6-4-2021 Permit Number. V
Io
ST. LC.ICIE
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:Bath Room Remodel
PROPOSED IMPROVEMENT LOCAT(.ON:. ;. ,„
Address: 9500 S. Ocean dr Unit 1204 Jensen Beach FL 34957
RECENBD
',SUN 11 2'021 aEcerl�o
BuildW PYnit Application im 9..0.111
rrnittInuC`e Department
Residential st.
Property Tax ID #: 4502-602-0108-000-8 Lot No.
Site Plan Name: Islandia II Condominium Unit 1204 Block No.
Project Name: O'Connor
DETAILED DESCRIPTION'OF WORK
Remodel Master and Guest Bathrooms Plumbing direct replacement and add recessed LED lights with new vent fans
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: 1200
Cost of Construction: $ 22'000.00
_ Generator
_ Windows/Doors _ Pond
Sq. Ft. of First Floor:
_ Roof Pitch
Utilities: -Sewer _ Septic Building Height:
OWNER/LESSEE:
CONTRACTOR
Name Edward & Betty O'Connor
Name: Robert Helmsorig
Address:9500 S. Ocean Dr Unit 1204
Company: Renovation Technologies
City: Jensen Beach State: f�
Address:21569 Battery Park Terrce
Zip Code: 34957 Fax:
City: Boca Raton State: FL
Phone No.201-370-7531
Zip Code: 33428 Fax:
E-Mail:bettyo@optonline.net
Phone No954-632-0698
E-Mail renovationtechinc@yahoo.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
State or County License CGC1 522634
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.
S,.UPPI,EMENTA! CONSTI UCTION,..lIEN£LA, - INFORMATION
Not Applica
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
*Ith lender or an attornev before commencing work orAcording vour Notice of Commencement.
I U I 1 4//// / I // I /////I r- "I --
Signature of
Agent for Owner
STATE OF FLORIDA v STATE OF FLORIDA
COUNTY OF 5� COUNTY OF S4 %-ocI e,
Sworn to (or affirmed) and subscribed before me of
�/ Physical Presence or Online Notarization
this/O day of �Oyle— .2020 by
&0-4141 A44,1&495
Name of person making statement.
Personally Known _� OR Produced Identification
Type of Identification
Produced
Sworn to (or affirmed) and subscribed before me of
K Physical Presence or Online Notarization
this _L0 day of )Uv1--- 2024 by
Name of person making statement.
Personally Known )c OR Produced Identification
Type of Identification
Produced
ASIgnature of Notary Y'..
e i R� Es NARBUTAs
(Sigrpature of Notary P li ' of = "An'' "'
Nota I c - State of Florida
Notary Public State of Florida
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< Comm' ion
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HH 028442
Commission No. ;%' "" Commi(SeraE HH 028442
Commission No. ;�,� ,_
My Com� 1tJsAug
5, 2024
or, • '
My Comm. Expires Aug 5, 2024
Bonded through National
Notary Assn.
Bonded through National Notary Assn.
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