HomeMy WebLinkAboutBuilding Permit Application_000296All 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: Island Kitchen & Bath
PROPOSED IMPROVEMENT LOCATION
_ -
Address: 8880 S Ocean Drive, Unit 405, Jensen Beach, Florida 34957
Property Tax ID #: 3535-602-0029-000-9 Lot No.
Site Plan Name: Window/Door Permit Block No.
Project Name: Holden Window/Door Project
I DETAILED DESCRIPTION OF WORK:
Remove and replace windows/sliders with EGS SM1130 Impact sliders & EGS Impact RMPT-SMI Windows
New Electrical Meter _ Second Electrical Meter
L'CONSTRUCTION INFORMATION:
.............__i
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: $ 42000.00 Utilities: —Sewer _Septic Building Height: _
OWNER/LESSEE:CONTRACTOR
Name Dave Holden (Name: Justin ihiery __..
Address: 8880 S Ocean Drive, Unit 405 I Company: Island Kitchen & Batyh
j City. Jensen Beach State: Address-, 10875 S Ocean Drive
Zip Code: 34957 Fax:_ .._. City: Jensen Beach State: FI
Phone No. 302-379-7799 ._._ _._.. _ Zip Code: 34957 Fax:
E-Mail: dholden@ingerman.com Phone No 772-237-7348
Fill in fee simple Title Holder on next page ( if different E-Mail ikb.pni.assistant@gmail.com
from the Owner listed above) State or County License CBC1259508
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 CONST UCT101",j LIEN LAW INFORMATION:
DESIGNER%ENGINEER: ____-Not Applica11 ble 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 noyywork or installation has commenced prior to the issuance of a permit.
wthich is iCounty
o onffimakes
w th any pplicable Home Owners Associati Association rules,ab� bylaws that proh
oizer and covenants maydresrrsubject
restrict bit 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 the Florida
plans, 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
w th lender organ attorney before commencin work or recording our Notice of Commencement.
Signaue of Owner) Lsee/Contractor as Agent for Owner
Sjtayure of Contractor/Lic s Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY OF 51 Ludes
Sworn to (or affirmed) and subscribed before me of
physical Presence Online
Sworn to (or affirmed) and subscribed before me of
i
or Notarization
this /^ day of Cd 2029f by
x Physical Presence or Online Notarization
this _[_ day of Q�C�F�_ 202/ by
' 1 6h W ;{` Alt d "FtD(Il ffK.)
Justin Thiery
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification "
Personally Known x OR Produced Identification
Type of Identification
Type of Identification
Produced oL
Produced
(Signature of Notary Public- t of Florida)
t
('gnature f Notary blic- S of Florida i
o10 pu& ICHAEL RAAZ
Commission No? * yssion#Giqk0
o1iAy Pu°t AEL RAAZ
Commission' ton.#GG3186$6eal)
N o� Expires July 28, 2023
Expires July 28, 2023
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REVIEWS FRONT ZONING SUPERVISOR
PLANS VEGETATION SEA TURTLE MANGROVE
I
COUNTER REVIEW REVIEW
DATE
REVIEW REVIEW REVIEW REVIEW
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RECEIVED
DATE
COMPLETED
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