HomeMy WebLinkAboutBuilding PermitApplication All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
L `` 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 CBDG Funding
PERMIT APPLICATION FOR: —
LPRO^POSED IMPROVEMENT LOCATION:_ _
Address: 10410 S. Ocean Dr.Jensen Beach, Florida 34957
Property Tax ID# 4511-514-0000-000-0-common areas Lot No.
Site Plan Name: Block No.
Project Name: Hutchinson Island Club
I DETAILED DESCRIPTION OF WORK:
New door replacement, see Engineer's specification
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:$ $ 15,072 Utilities: _Sewer _Septic Building Height:
r.a,.._ __ —_—�-. _ -----_ — __ — ---
O W N ERAESSE E: CONTRACTOR:
Name Hutchinson Island Club Name: Patricia Salazar
E Address: 10410 S.Ocean Dr. _ Company: DANIELLO,SALAZAR 8 SONS,INC.
City: Jensen Beach State:_ Address: 2708 N.Australian Ave.
Zip Code: 34957 Fax: City: West Palm Beach State:Fl.
Phone No.
t E- Zip Code: 33407 Fax: 561-833-3573
Mail: t'TGt!I'e�t 1:f214 I(A Phone No 561-835-4788
` Fill in fee simple Title Holder on next page(if different ( E-Mail info@concreterepairing.net
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from the Owner listed above) State or County License CGC1524218 P
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: N ot Applicable MORTGAGE COMPANY: _Not Applicable
Name: CSM-Engineering.LLC Name:
Address: 208 SW ocean Blvd Address:
City: Stuart State: City: State:
Zip: 2e4194 Phone 772-22n_4sn1 Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable I 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 conflicts with any applicable Homeowners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Homeowners 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 your Notice of Commencement.
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Signature of O ner LesseeJContractar ts Agent for Owner
STATE OF FLORIDA
COUNTY OF if(
Sworn to or affirmed)and subscribed before me of _Physical Presence or�Online Notarization
this ay of t LL_ .2Q--.>) by
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Name of person making statement. 4
j Personally Known OR Produced Identification
Type of Identification Produced
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(Signai ure of
ysY+K' Notary Public State of Florida
Commission N LorraiTp,,4 Lino
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REVIEWS FRONT ZONING SUPERVISOR 1 PLANS VEGETATION SEA TURTLE MANGROVE I
I COUNTER REVIEW REVIEW J REVIEW REVIEW REVIEW REVIEW 1
DATE
RECEIVED i
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COMPLETED I i
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