HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFQQMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Oj
Date: P 00 / Permit Number: O
RECEIVED
Building Permit Application UG 18 2021
Planning and Development Services
County
Building and Code Regulation Division St. Lucie Li
Permimngng
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial X Residential
PERMITTYPE: Replacement of obr
PROPOSED IMPROVEMENT LOCATION:
Address: 9900 S Ocean DR Jensen Beach, FL 34957
Property Tax ID #: 4502-244-0001-010-3 Lot No.
Site Plan Name: Oceana Association Block No.
Project Name: Oceana Association
Replacement of bno{
FLNOA aafj��� 1
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers _ Generator
Total Sq. Ft of Construction: _
Cost of Construction: $ 6,557.57
Sq. Ft. of First Floor: _
4 Windows/Doors
Roof Pitch
Utilities: —Sewer _Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Oceana Assn Inc
Name: Jeffrey Walsh
Address: 9900 S Ocean DR
Company: Liberty Home Builders
City: Jensen Beach State:—
Zip Code: 34957 Fax:
Phone No. 772-486-0284
Address: 257 SE Monterey Road
City: Stuart State: FL
Zip Code: 34994 Fax: 772-324-8578
Phone No 772-486-7711
E-Mail: oceanarecassociation@gmail.com
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail connor@Iibertyimpactwindows.com
State or County License CGC 1504157
it value of construction is 5Z500 or more, a RECORDED 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:
DESIGNER/ENGINEER: Not Applicable
MORTGAGE COMPANY: Not Applicable
Name: ITV i i'li�JlS
Name:
Address:
Address:
City: State: �
City: State:
Zip: 3•I1-;,t__ 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 YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON T J SITE BEFORE THE FIRST INSPECTION. IF YOU INT OBTAIN FINANCING, CONSULT
WITH YOUR R OR AN ATTORNEY BEFORE RECORDING YO R NQXKE Pt COMMENCEMENT."
(fgnWe'b+dn
essee/Contractor as Agent for Owner
Ignature of ont ctor/Lic se Holder
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF
COUNTY COUNTY OF
The fo going instru ent wa acknowledged before me
The f going instru nt was acknowledged � efore me
this c� day of 1; 2041 by
this day of 20 1 by
Jeffrey Walsh
Jeffrey Walsh
Name of person making statement.
Name of person making statement.
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type f Identification
Type of Identification
Prod ed
Produce
�CHRISTINA FORTIN
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Commission No. GG937464 Seal
Commission No. GG937464 (Seal)
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ev.
CHRISTINA FORTIN
�•8��:. Notary Public - State of Florida
CHRISTINA FORTIN rNotar Commission # GG937464
C
-� y Public - State of Florida 9`; ✓F. FX fires Dec 5, 2023
My Comm. Expires Dec 5, 2023
Bonded through National Notary Assn.