HomeMy WebLinkAboutBUILDING PERMIT APPLICATION All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
LUUit
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential X
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR:Demolition
PROPOSED IMPROVEMENT LOCATION:
Address: 10701 S Ocean Dr#634 Jensen Beach FL 34957
Property Tax ID#:4511-805-0035--000-6 Lot No.634
Site Plan Name: Block No.
Project Name:
[DETAILED DESCRIPTION OF WORK:
demo single family residence
New Electrical Meter Second Electrical Meter (Affidavit required)
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: $ ��� Utilities: _Sewer _Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
NameDenbse Worsmp Name: James Newman
Address:10701 S Ocean Dr#634 Company: JWN Builders LLQ
City:Jensen Beach State: FL Address.1701 S Carvalho St.
Zip Code: 34957 Fax: City:Port St. Lucie State:FL
Phone No. 727-698-2010 Zip Code.34983 Fax: 772-871-9500
E-Mail: Phone No 772-201-8947
Fill in fee simple Title Holder on next page(if different E-Mail jwnconstruc#ion@comcast.net
from the owner listed above) State or County LicenseCRC1328282
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 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 recordin our Notice of Commencement.
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_(2 24J&'-.9nA
ignAure of Owner/Lessee/Contractor s Agent for Owner
STATE OF FLORIDA
COUNTY OF
Sworn to r affirmed nd subsc 'bed befor me of Physical Presence or Online Notarization
this y of 20,21 by
Name of person making statement.
Personally Known OR Produced Identification
Type of Ideptificati Produced
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(Signs ure of Notary Public-State of Florida)
Commission No. (S i4:i,RYPb', SHARONK.NEWM
Commission#HH091U74
Via• Expires ApN 20,2025
Banded 7hru Troy Fain Insurance 800.38 1049
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DATE
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DATE
COMPLETED
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