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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAII APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date:Permit Number: Building Permit Application Plonninq and Development Services Building and Code Regulotion Division 2j00 Virqinio Avenue, Fort Pierce FL 34982 Phone: (772) 462-1553 Fax: (7721 462'1578 Commercial x Residential CBDG Funding Address: 8650 S. Ocean Dr. Jensen Beach, Florida 34957 South Building Property Tax lD #: Site Plan Name: Lot No Block No. Project Name:Regency lsland Dunes Condominium Association New Electrical Meter -- Second Electrical Meter (Affidavit required) Additional work to be performed under this permit - check all that apply: _Mechanical - Gas Tank _ Gas Piping _ Sprinklers _ Shutters _ Generator Sq. Ft. of First Floor: Windows/Doors - Pond _ Roof -- Pitch_ Electric _ Plumbing Total Sq. Ft of Construction: cost of construction: s ggz,g+z utilities: - sewer - septic Building Height: Name Reqencv lsland Dunes Condominium Associationl N"r"' Patricia Salazar Address: 8640 S. Ocean Dr. I co-prny' DANIELLO,.SAI=AZAR & SONS, INC' City: Jensen Beach State: Fl.Address: 2708 N,{q!gele! 3ye' Zip Code: 34957 Fax:City: West Palm Beach State: -Phone No.Zip Code: 33407 Fax: 1y1311. ridmgr@the-regencY.com Fill in fee simple Title Holder on next page (if different from the Owner listed above) Phone No 561-835-4788 E-Mail info@concreterepairing.net State or County License ffire,aRECoRDEDNoticeofCommencementisrequired. PERMIT APPLICATION FOR: PROPOSED IMPROVEMENT LOCATION: DETAILED DESCRIPTION OF WORK: Concrete repairs - CONSTRUCTION INFORMATION : OWNER/LESSEE: lf value of HAVC is 57,500 or more, a RECORDED Notice of Commencement is required' !i i ii ',i,L!L!L! SU P PLE M ENTAL CONSTRU CTION LI EN LAW I N FORMATION : DESIGNE _ Not Applicable MORTGAGE COMPANY: Name: _ Not Applicable Name: CSM - Engineering. LLC Address: 206 SW Ocean Btvd City: Strrart State: Fl. Address: City:State: Zip'. zqss+Phone 772-220-4601 FEE SIMPLE TITLE HOLDER:_ Not Applicable BONDING COMPANY: Name: _Not Applicable Name: Address: City: 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 Countv makes no reDresentailon that is srantinp a oermit will authorize the oermit holder to build the subiect structure which conflicts with anv apol'icable Homeownerstrssocia"tioh rules. bvlaws or and coJenants that mav restrict or or6hibit such structure. Please consult with your Homeowners Association and ieview your deed for any restrictiois which maV apply. ln 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. lf you intend to obtain financing, consult with lender or an attorney before com work or record r Notice of Commencement. ture of Owner/ Les ntractor as Agent for Owner l/ STATE OF FTORIDA^ . :JlHlEVrrLVnlYn^ cou-,iiil di-':' -^s+ . \x ue Swor4 1o (or affirm-ed) and supscribed before me of Y Phvsical Presence or Online Notarization tnis 2i Jav of St , zofjoy Name of person making statement. Personallv Known y OR Produced ldentification CASSANDRA PIERSON MY COMMISSION #HH.I 39620 EXPIRES: JUN 08, 2025 Eonded thr0ugh 1st State lnsurance Type- of ldentification Rioduced Cn^^*?,^; (Signature of Notary Public- State of Florida) Commission r.ro.tl-Ut30 b?O (s".t) REVIEWS FRONT COUNTER ZONING REVIEW SUPERVISOR REVIEW PLANS REVIEW VEGETATION REVIEW SEA TURTLE REVIEW MANGROVE REVIEW DATE RECEIVED DATE COMPLETED Zip: _ Address: City: Zip:Zip: _ Phone: