HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 12/20/21 Permit Number: I • V�� ,
RECEIVED
Building Permit Application DEC 2 12021
Planning and Development Services St. Lucie County
Building and Code Regulation Division Permitting ry
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial x Residential
PERMIT TYPE: Exterior doors
PROPOSED IMPROVEMENT LOCATION;
Address: 9500 S. Ocean DR Jensen Beach FL 34957 Unit 503
Property Tax ID #: 4502-602-0037-000-9
Site Plan Name: ISLANDIA II CONDOMINIUM UNIT 503
Project Name: Cale
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK:
Direct replacement sliding glass doors
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors
_ Electric _ Plumbing _ Sprinklers _ Generator _ Roof Pitch
Total Sq. Ft of Construction: 1100
Cost of Construction: $ 9500.00
Sq. Ft. of First Floor:
Utilities: _ Sewer _ Septic Building Height:
OWNER/LESSEE:: ,
CONTRACTOR:
Name Priscilla Cale
Name: Robert Helmsorig
Address: 9500 S. Ocean DR Jensen Beach FL 34957 Unit 503
Company: Renovation Technologies
City: Jensen Beach State:.fL--
Address: 21569 Batter Park Terrace
Zip Code: 34957 Fax:
City: Boca Raton State: FL
Phone No. 860-478-6814
Zip Code: 33428 Fax:
E-Mail: (,Ar&A(e a. gmwl _ CntM
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
..p
it value of construction is $2500 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:
Name:_
Address:
City: _
Zip:
Phone
_ Not Ap
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
TH YOUIO LENDER OR AN ATTORNEY BEFORE RECO INd YOUR NOME OF COMMENCEMENT."
e
Signature of Con rac or/License Holder
Signature of Own r/ Lessee/Contracto Agent for Owner
STATE OF FLORIDA
COUNTY OF S� L
STATE OF FLORIDA
c�Ci a
COUNTY OF �S' Luc) e__
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this ZI day of DeCeo4f - , 20_7,1 by
this 21 day of QeCep4-e✓ , 20 21 by
gibber-� fle!
Ober} o c,
ofl
Name of person making statement.
Name of person making statement.
Personally Known _ K OR Produced Identification
Personally Known �C OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notary Pu.
(Signature of Notary Public-
1i�Y' "' • RONALD JAMES NAR8UTA5
'� j
�'� Y.p " •., RONALD JAMES NARBUTAS
Commission No. t�o{ Mile • State of Florida
Com(nnission # HH 021442
ommission No. ' � Notary Ppq l tate of Florida
ON •..... oF ? My Comm. Expires Aug 5, 2024
Qۥ Comm ss on HH 028442
ozP y y-z ca . My Comm. Expires Aug 5, 2024
REVIEWS
FRONT
PLANS
VEGETATION
MANGROVE
ZONING
SUPERVISOR
SEA TURTLE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 2/713.9