HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED I �Q Date: Permit Number: 1 v0 ' U1141
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT TYPE: Remodel
PROPOSED IMPROVEMENT LOCATION:
RECENED
Building Permit Application NUG 11 1011
St. Lucie, County
PermOng
Commercial x Residential
Address: 9500 S. Ocean DR Unit 1801 Jensen beach FL 34957
Property Tax ID #: 4502-602-0165-000-5
Site Plan Name: Islandia II Condominium
Project Name: Cech
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK: 1
Master Bath Remodel, Plumbing, Electric, Tile, Cabinets
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
Electric )CPlumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: 100 SQ FT Sq. Ft. of First Floor:
Cost of Construction: $ 10'000.00 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Kenneth & Christine Cech
Name: Robert Helmsorig
Address: 9500 S. Ocean DR Unit 1801
Company: Renovation Technologies Inc
City: Jensen Beach State:
Address: 21569 Battery Park Terrace
Zip Code: 34957 Fax:
City: Boca Raton State: FL
Phone No. 772-229-0115
Zip Code: 33428 Fax:
E-Mail: mmdd47@gmail.com
Phone No 954-632-0698
Fill in fee simple Title Holder on next page (if different
E-Mail renovationtechinc@yahoo.com
from the Owner listed above)
State or County License CGC1522634
IT value of Construction Is >LSuu or more, a 11MUKDED Notice of commencement is required.
If value of HVAC Is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNE
Name:_
Address:
City: _
Zip:
Phone
_ Not Applicable
State:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
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 YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
W YOUR LENDER OR AN ATTORNEY BEFORE RECORDtN"OIJR NOTICE OF COMMENCEMENT."
�4 - IWO"
Signature of Owner/ essee/Contractor a Vlent for Owner
Signature of Contract r/ icense Holder
STATE OF FLORIDA S�((
COUNTY OF �,.liG
STATE OF FLORIDg,f
LUC1 e-
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COUNTY OF 9-
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this day of %4"12 1 , 20 - by
this Q_ day of , 20� by
�� �iF�-r�-��o�1-c..�,
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Name of person making statement.
Name of person making statement.
Personally Known \ OR Produced Identification
Personally Known ✓ OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
igna ure of Notaryubli $� ' ' t Flory A D JAMES NARBUTAS
(Signature of Notary Publ' -,S< •Q 00 p DAMES NARBUTAS
Notary Public - State of Florida
Commission No. '`.• k) ion � HH 028M2
Notary Publi - State of Florida
Commission No. '. e`° Con( q HH 028442
My Comm. Expires Aug 5, 202�
B°nded through National
°F-' My Comm. Expires Aug 5, 2024
Bonded
Nota Assn.
through National Notary A.
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