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HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONr_ s ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED Date: // Permit Number: SCANNED BY Building Permit Application St. Lucie County 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 APPLICATION FOR: To Select from dropbox, click arrow at the end of line PROPOSED'IM'OROVEMtNTLOCATION: Address: 10410 S OCEAN DR, JENSEN BEACH, FL 34957 Legal Description: HUTCHINSON ISLAND CLUB Property Tax ID #: 4511-514-0000-000/9 Site Plan Name: Project Name: Setbacks Front Back: _ Right Side: Left Side: Lot No. Block No. „.DE,TAILED DESCRIPTION OF WORK ; .n DOOKIREPLACEMENTf—o4Fjm04�— �^��J' — /a:-Cg`a— 7' t>7©J� ! T4i �X l i (,'CONSTRUCTION INFORMATION: _'',' LAHVAC L_j Gas Tank 1-1 Electric 0 Plumbing Total Sq. Ft of Construction: Cost of Construction: $ 2000.00 nit— cnecKall apply: Piping In Shutters ars 11 Generator S Ft. of First Floor: _ Utilities:Sewer Septic ZWindows/Doors L1 Roof Building Height: "OWN'ER/LESSEE ;� ,_,r .,, . �., CONTRACTOR Name HUTHINSON ISLAND CLUB Name: MICHAEL ROBERTS Address:10410 S OCEAN DRIVE Company: SPECIAL FORCES City: JENSEN BEACH State: FL Zip Code: 34957 Fax: Phone No. 772-334-2990 Address: 1235 NE DIXIE HWY City: JENSEN BEACH State: FL Zip Code: 34997 Fax: 772-334-4131 Phone No. E-Mail: tammy@specialforcesus.com Fill in fee simple Title Holder on next page ( if different from the Owner listed above) E-Mail: tammy@specialforcesus.com State or County License: CGCO59083 If value of construction is 52500 or more, a RECORDED Notice of commencement is regwrea. SUP,PLEMENTAL;CONSTRUCTION"LIEN"LAW INFORMATION: DESIGNER/ENGINEER: _ Name: CSMENGINNERING Not Applicable MORTGAGE COMPANY: _ Not Applicable Name: Address: 208, BE OCEAN BLVD SUITE,A Address: City: STUART Zip: 34888 Phone: 772-220-4e01 State: FL City: State: Zip: Phone: FEE SIMPLE TITLEHOLDER: _ Name: Not Applicable BONDING COMPANY: _Not Applicable Name: Address: Address: City: City: Zip: Phone: 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 S _ Signat re of Owner/ Lessee/Agen Signature of Contractor/License Holder STATE OF FLORIDA COUNTY OF MARTIN The for oing instrument was acknowledged before me this day of yn&44[4 20 LSby MICHAEL ROBERTS (Name of person acknowledging) (Signature of Notary Pii Cc State of Florida ) Personally Known x •f� OR Produced Identification Type of Identification Produced Commission Noff 0 L(SS (Seal) STATE OF FLORIDA COUNTY OF MARTIN The forgoing instrument was acknowledged before me this _?Sday of d 20 /f by MICHAEL ROBERTS (Name of person acknowledging) (Signature of Notary Pu ic- State of Florida ) Personally Known x OR Produced Identification Type of Identification Produced Commission No. t 7.55 (Seal) * M WWlSV0NOFF014W i MYGW6MWONOFF0141154 Revised07/15 EXPRE&MBYS,2017 y EXPIRES:Msy5,2o17 ,.n� awrtt.,,udeetM.tavSrtas •he.nwo BrMTh IIkWNVbmS@Nkn REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW DATE COMPLETE INITIALS