HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONr
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: �� Permit Number:
SCONE[
sly
a Lude County
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
PERMIT APPLICATION FOR: Renovation
PROPOSED IMPROVEMENT LOCATION:
Address: 9401 S. Ocean Drive., Apt. 4A, Jensen Beach, FL. 34957
/job _00/ 0 .
FEB _ 1.2018
Residential X
Legal Description: ISLAND VILLAGE -PHASE I- TOWNHOUSE UNIT 4A AS SHOWN ON DECLARATION OF PARTY FACILITIES AS RECORDED IN OR 352-1938 (OR 3983-2868)
Property Tax ID #: 3535-334-0003-130-9
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Lot No.
Block No.
:DETAILED DESCRIPTION OF -,WORK:
Enlarge Pass-Thru opening. Extend Soffit. Install New Recess Lights and repair any Drywall
damage. Plumb New Sink & Faucet (same location). Paint walls and trim.
CONSTRUCTION INFORMATION`
Ac1clitional work to be nertormed under tispermit—check
all
apply:
E1HVAC
0
Gas Tank
❑Gas Piping
Shutters
a Windows/Doors
R1Electric 0
Plumbing
_
L
1:1
Sprinklers
Generator
Roof
Total Sq. Ft of Construction: 120sgft
S Ft. of First Floor:
Cost of Construction: $ 6,525.00
Utilities:
Sewer
0
Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name R Wesley Campbell Jacquelene M Campbell
Address: 9401 S Ocean DR Apt 4A
Name: Nathan Cooke
Company: Cooke Construction, Inc
City: Jensen Beach State: FL
Zip Code: 34957 Fax:
Phone No.1-260-403-3834
Address: 1278 Business Park Place
City: Jensen Beach State: FL
Zip Code: 34957 Fax:
Phone No. 772-530-0659
E-Mail: wescamllo@gmail.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail: nate@cookeconstructioninc.com
State or County License: CGC1520585
IT value or construction is }Zsuu or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
Address:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
BONDING COMPANY: Not Applicable
Name:
Address:
City:
Zip: Phone:
City:
Zip: Phone:
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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an attorney before
commencine work or recordinta vour Notice of Commencement. 1-1 -.1
_ Signature of Owner/ Lessee/Agent
STATE OF FLORID/, 1COUNTYOF
STATE OF FLOMCOUNTYOF �//�✓'�-1 )(-ayX
The forgoing instrument was acknowledged before me
this 31 day of . 20 18 by
(Name of person acknowledging)
Si ature of Notary Public- State of Florida )
Personally Known QR Produced Identification
Type of Identification Produced
Commission No. GG — lc i;�y;
- '. • WALTER.D PAYNE41
The forg�ng instrument was acknowledged before me
this ?! day of 20 by
(Name of person acknowledging)
(91griature of Notary, Public- Sta a of Florida
P)
Personally Known !/ Produced Identification
Type of Identification Produced
n No. Glj--2, g4167
(Seal)
• : �•'•= Commission # GG'24467 -i°;� V�`�'•; Notaiy'Public • State of Florida
Revised 07/15/2014 My Comm. Expites Aug 25; 2020 '• Commission .# GG'24467
Bonded Through National Notary Assn. e:� M m
REVIEWS
FRONT
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REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
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VEGETATI
REVIEW
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REVIEW
REVIEW
DATE
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