HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 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 FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 10851 S OCEAN DR LOT 169 JENSEN BEACH, FL 34957
Property Tax ID#: 4511-809-0002-000-8
Lot No. 169
Site Plan Name: WINDMILL Block No.
Project Name: WINDMILL VILLAGE
f DETAILED DESCRIPTION OF WORK:
REMOVE EXISTING 15' X 5' CHAIN LINK FENCE & GATE. REPLACE WITH 10' X S ALUMINUM PICKET FENCE
AND 5' X S ALUMINUM PICKET GATE.
New Electrical Meter Second Electrical Meter (Affidavit required)
E4N:S�TRUC�TION 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: $ 2500.00 Utilities: -Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name WINDMILL VILLAGE BY THE SEA COND0#1 AS CIQme: TED NIELSEN
Address: 10851 S OCEAN DR LOT 169 Company: ARC WELDING & FABRICATION
City: JENSEN BEACH State: FL Address: 1720 SW BILTMORE ST
Zip Code: 34957 Fax: City: PORT ST LUCIE State: FL
Phone No. 248-396-4033 Zip Code: 34984 Fax:
E-Mail: JOHDREA@GMAIL.COM Phone No 772-333-2334
Fill in fee simple Title Holder on next page ( if different E-Mail arcweld3(a gmail.com
from the Owner listed above) State or County License CGC1506611
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.
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: — Not Applicable BONDING COMPANY: Not Applicable
Name: 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 commencing work or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Ap{ent for Owner
STATE OF
COUNTYOFORIDJ��¢
Sworn to(pir affirmed)and subscribed before me of '�Physical Presence or Online Notarization
this Of clay of A-t f,�( Jam--'202,1 by
Name of person making statement.
Personally K wn ✓ OR Produced Identification
Type d tification Produced
� L n
(Signature of Notary Public-State of Florida)
V►r Notary Public State of Florida
Commission No.6U ��� �� seal Kathie LWhitaker
(seal) � � My Commission GG 277089
or id Expires 1 111 5/2 0 22
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev5120/21