HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COM�..� ED FOR APPLICATION TO BE ACCEPTED
Date: 06/22/2021 Permit Numbera`\tez_a,�Iga
RECENED
0
°' Building Permit Application
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: Spa Renovation
PROPOSED`IMPROVE,MENT LOCATION
Address: 8640 South Ocean Drive, Jensen Beach, FL 34957
Property Tax I D #: 3534-111-0009-000-3
Site Plan Name: Sec 34 Twn 36S Rng 41 E
Project Name: Regency Island Dunes
DETAILED D.ESCRIPTIO,N;OF.INQRK
Install FL Gem Finish 3/8"-1/2" thick
Bring all Main Drain Covers to Code
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION .
JUN 2 3 2021
raffmMV
Residential
Lot No.
Block No.
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: $ 4,500.00 Utilities: —Sewer _ Septic Building Height:
01NR%LESSEE:CONTRACTOR:
NE
Name Regency Island Dunes
Name: Dustin Hardy
Address:8640 South Ocean Drive
Company:Aquatic Surfaces Of Tresure Coast Inc.
City: Jensen Beach State: _
Address:635 NW Buck Hendry Way
Zip Code: 34957 Fax:
City: Stuart State: FL
Phone No.772-229-0311
Zip Code: 34994 Fax: 772-334-7243
E-Mail:regency8640@the-regency.com
Phone N0772-225-4389
Fill in fee simple Title Holder on next page ( if different
E-Mail dh.aquatic@gmail.com
State or County License CPC1459110
from the Owner listed above)
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.
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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:
ZC 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.
rSignaf re of Owner/ Lessee/Contractor as Agent for Owner
Si n ture of Contractor/Licee older
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF /y�IJLT//11
COUNTY OF 1'%4477111
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
X Physical Presence or Online Notarization
Physical Presence or Online Notarization
this -" day of '4 ou c , 2021 by
this ®23 day of J-4eye 2021 by
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l%us 77,V 1T,*" 5'
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification X
Personally Known ON OR Produced Identification
Type of Identification
Type of Identification
Produced PR 1 VC-72s' % l C
Produced
L(Signatur iNotar PupliC- State of F1�rr ►�, ELEMORK
((Si nature of Notar Public- State fl ida
g y ` ) ELEANOR KOVARIK
Commission # HH 10
May22,2
Commission No. _ttfi-f/O2/!/ �)FpF�O� )
11'I :• ,.••.•�4 Commlti w N HH 102111
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