HomeMy WebLinkAboutBuilding PermitAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 3/29/2021 Permit Number:
(D k,
�~- 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: Interior Remodel
PROPOSED IMPROVEMENT LOCATION:Regenceny Island Dunes II
Address: 8600 S Ocean Dr, PH5, Jensen Beach FL 34957
Property Tax ID #: 3534-502-0071-000-8 Lot No.
Site Plan Name: Block No.
Project Name:
DETAILED DESCRIPTION OF WORK:
Kitchen Remodel, Master Bathroom Remodel, Remove existing tile, Install new 1/2" cork undertayment and tile. New trim and paint.
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors _ Pond
k Electric x Plumbing
Total Sq. Ft of Construction: 1,929
Cost of Construction: $ 30,000
Sprinklers _ Generator _ Roof Pitch
Sq. Ft. of First Floor:
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Donald W Westphal
Name: Dana Smith
Address:8600 S Ocean DR PH 5
Company: Dana Smith & Sons Construction, LLC
City: Jensen Beach State: _
Zip Code: 34957 Fax:
Phone No.262-490-3621
Address:1717 SW Buckskin Trail
City: Stuart State: FL
Zip Code: 34997 Fax:
Phone No561-846-2024
E-Mail Dana.n.sons@gmail.com
State or County License CGC1518333
E-Mail:
Fill in fee simple Title Holder on next page ( if different
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.
0
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 recording our Notice of Commencement.
Signature of Owner/ Lessee/Contractor as Agent for Owner
Sig ei of Contr for/Li a Holder
STATE OF FLORIDA
STATE OF FLORID
COUNTY OF QJCtI%iiVl
COUNTY OF
Swof� to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
V Physical Presence or Online Notarization
this � day of ` 2024 by
Physical Pres nce or Online Notarization
this IZ, day of 2021 by
Ocioc,\CJ I;,}F , 1)\-C�\�k_
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Name of person making statement. I
Na�e bf person making statement.
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Personally Known OR Produced Identificationy
Personally Known OR Produced Identification
Type of Identification _
Produced{ C�LI��;Z?J\1nC13�i�jy
Type of Identification
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