HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONL APPLICCABLE INFO MUST BE COMPLY c'O FOR APPLICATION TO BE ACCEPTED
Date:TJ� SCANNED Permit Number:
BY
St. Lucie County
Building Permit A
Planning and Development Services
Building and Code Regulation Division
2300-Wrglma ve�l'ort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial
LRECEIVED
pplicatioCT 25 201,8
e County, Permitting ,
Residential
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line KQLMo Vq+10 Y\
PROPOSED IMPROVEMENT LOCATION:
Address: 8750 SOUTH OCEAN DRIVE, JENSEN BEACH, FL 34957/3.S
Legal Description:
Property Tax ID#: _13S35-roll
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Lot No.
Block No.
'DETAILER DESCRIPTION OF WORK
1J 2�7 y�t'tT.J.�fi�l �131N2�T5 arvD
Nco._a 'aAT�tZcx>r�n vl�,i;V�T�I p..�iq 541w.�� �✓I (/���I JN ���
CONSTRUCTION INFORMATION:
a
11HVAC
LJ
Gas Tank
[]Gas
Piping
UShutters
❑
Windows/Doors
Electric
QPlumbing
Sprinklers
Generator
Roof
=
Roof pitch
Total Sq. Ft of Construction: I , Sbo
Cost of Construction: $ Z 6t oc� 0
S Ft. of First Floor: _
UtilitiesSewer DSeptic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name LARRY FRYER
Name: t/L✓L) L 60C15
Address: 70 JON BARRETT RD
Company: A-YQ4z -- ey42glJ5
City: PATTERSON State: NY
Zip Code: 12563 Fax:845-878-2525
Phone No.914-656-2148
Address: I (&k A)6 {Lt24�G�� S d
City: -�aiSCA /3Cc{ZA' State: rL
Zip Code: 3wFax:
Phone No. 561- 2_(I f-- Zf$5Z
E-Mail: LFRYER@FRYERMACHINE.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: Cam. &901SCo/'420- UctGov. (,v 1:21
State or County License:
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
UPPLEMENTAL CONSTRUCTION'LIEN IAW.INFC?RMATION
DESIGNER/ENGINEER: _ Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name: �RRVFRVER
Name:
Add reSS: 8750 SOUTH OCEAN DRIVE, JENSEN BEACH, FL 34957
Address: 70JONBARRETTRD
City: PATTERSON State:
City: State:
Zip: 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 that
or and covenants 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 rider or an attorney before
commencing work or recording our Notice of Commencement.
Signature Lessee/Contractor as Agent for Owner
Signature of Cont actor/License Holder
STATE OF FLORIDA
STATE OFF LORIDA
COUNTY OF S�z�ccaS�
COUNTY OF_�I f i.(J?i
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this 2.o day of 20 'r by
this `/) day of C3G*64,!:/ 20_&I by
Name of person making statement
Name of perso aking statement
rOR
Personally Known_ OR Produced Identification
Personally Known Produced Identification
Type of Identification
Type of Identification
Produced
Produced
i f�Otary Public- St a -
f Notary Public- Stat '
•4� p ••
;••••`°k;:_ :IAAIINEN.STOKES
s.
Commission No. 6 % �3e�Yj�MMISSIONSGGI8'b
T'e.7oy•..
JA2MINE N. STOKE
fission No.�7 RNCOMMISSIONtIGG
°'S Septem6er19.
'FpFnq? Nagy
=; o`; EXPIRES: September18
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?. BOndBd Thm Notuy Public
REVIEWS
FRONT ZONING
SUPERVISOR
PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW
REVIEW REVIEW
REVIEW REVIEW REVIEW
RECE'IVfD
DATE'
COMPLETED
1
Rev.8/2/17