HomeMy WebLinkAboutBUILDING PERMIT APPLICATION�i�h o3oro a o! R o��
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
SCANNED
- " BY
3t, Lucie 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
PERMIT TYPE: Structural
PROPOSED IMPROVEMENT LOCATION:' '
Commercial k—OP—PaResidential
Address: 9550 S Ocean Dr Unit 1509, Jensen Beach, FL 34957
Property Tax ID #: 4502-601-0143-000-2
Site Plan Name:
Project Name: Keith & Margo Caron
Lot No.
Block No.
DETAILED DESCRIPATION OF WORK:
�rf411 00 � ✓` c C- 0 M2 t 001 5(4 W—(ret-
.CONSTRUCTION.I NFORMATION:
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: 20 f ' ? Sq. Ft. of First Floor:
Cost of Construction: $ JYS Utilities: _Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Keith & Margo Caron - ..
Name: Edward J. Heritage
Addressr9550,S Ocean Dr #1509
Company: Folding Shutter Corporation
City: JensemBeach : <. a• - State: _
Zip Code, 34957„ r , r_ Fax: N/A
PFion'e`Nbr860-884-0778' ;
Addres`s:1862 Dr Martin Luther King Jr Blvd
City West"Palm Beach_ fE y State: FL
'Zip Code :: 33404 ' ^^' Fax: 561-640-8204
Phone No 561-683-4811
E-Mail: n/a.
Fill in fee simple Title Holder an next page ( if different
from the Owner listed above) "
E-Mail info@foldingshutters.com
State or County License SCC131151041
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.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGN ER/ENGINEER:-'
Name:
_ Not Applicable
MORTGAGE COMPANY:
Nahi6-
_ Not Applicable
Address:
Address:
City:
Zip: Phone
State:
City:. -,-,..t
Zip'. Phone:
State:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY:
Name:
_Not Applicable
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.
no
e the permit holder to build the subject structure
or and covenants that may restrict or prohibit such
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
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
forOwner /
ignaWc"f-Owners see -C_ ent
nature of Condo icense o
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF Palm Bean
COUNTYOFPa B-a
The forgoing instrument was acknowledged before me
At^*y
The forgoing instrument wa;acknowledged before me
this AA day of k 2070t by
thisAZdayof /KA 20911, by
Edward J. Heritage
Edward J. Heritage
Name of person making statement.
Name of person making statement.
Personally Known x OR Produced Identification
Personally Known x OR Produced Identification
Type of Identification
Type of Identification '
Prod d
Produced —
s
(Signature of Notary Public - State o a I Pamela A. Evans
(Signature of Notary Public -St vlorWelaA. Evan
n NOTARY PUBLIC
6'&24�ply
aQ NOTARY PUBLIC
sSTMARpFFLORIDA
Commission No. S QTATE OF FLORID
1
Commission No.
a Conan# GG282789
NRi
L;-&-Q � �7 a � Comm# GG262789
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
,
Rev.2/7/19