HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 4-6-2020 Permit Number: 200q— C) 7_0
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial �_ Residential
PERMIT TYPE: Residental remodel
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Address: 9500 S. Ocean Dr unit 503 Jensen Beach FL 34957
Property Tax ID #: 4502-602-0037-000-9 Lot No.
Site Plan Name: ISLANDIA 2 CONDOMINIUM UNIT 503 Block No.
Project Name:
r+1v9S ea/' GLx5r &41S.: OMAVVC-Ar (Zeml -e 6 ls4s CP4k%nC-n . Toffs 4 Imo, f7k6025
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: Sq. Ft. of First Floor: 1224
Cost of Construction: $ ZSDO O C>C: Utilities: _ Sewer _Septic
_ Windows/Doors
_ Roof Pitch
Building Height: 200'
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Name Priscilla Cale
Name: Robert Helmsodg
Address:34 Timber Ln
Company: Renovation Technologies
City: Willington State: CGS
Address:21569 Battery Park Terr,
Zip Code: 06279 Fax:
City: Boca RAton State: FL
Phone No.860-478-6814
Zip Code: 33428 Fax:
E-Mail: priscillacale@gmail.com
Phone No954-632-0698
Fill in fee simple Title Holder on next page (if different
E-Mailrenovationtechinc@yahoo.com
from the Owner listed above)
State or County License CGC1 522634
If 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.
INEER: ,_ Not Applicable
Name:
Address:
City: State:
zip:, Phone
FEE SIMPLE TITLE HOLDER: Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: KNot 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 considerationof 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 NTEND O OBTAIN FINANCING, CONSULT
WITH YOUR L.ENIPER OR AN ATTORNEY BEFORE RECORDING YQOIR NVFICEpjFIOMMENCEMENT."
STATE OF FL
COUNTY OF
TheMng instryy��merLt was acknowledg��,,d,n `b`efore me
thay of N 20 C(� by
QA u I-. wms Q � c�
Name of person makinggsstatement.
Personally Known I/ OR Produced Identification
Type of Identification
Produced
ignature of Notary Pu icy of ftVi &4blic State of Florida
Abigail Rae Langweiler
y;c . My C sion GG 225260
Commission No. _ expir�si2022
REVIEWS I FRONT I ZONING
COUNTER REVIEW
TE
DATE
COMI
re
STATE OF FLORIDA
COUNTY OF l/ fif
The forgoing instr ment was acknowledged before me
this ��ay of �\1 , 20 W by
Name of person making statement"
Personally Known �R, Produced Identification
Type of Identification
Produced
-(Wggnature of Notary Pu Iic,Ata of'4%; uc State or Florida
Abigail Rae Langweiler
Commission No. `Na My
pCes 06 05lY G 225260
SUPERVISREVIEWOR I REVIEW PLANS I VREVIEWON I SEATURTREV EWLE I MREV EWVE