HomeMy WebLinkAboutapplicationAll APPLICABLE INFO MUST BE C
Date: 12/3/19
FOR APPLICATION TO BE ACCEPTED + (� n
Permit Number: 1. ,) li 0 )M,
RECEIVED
DEC 112010
Building Permit Application
Planningand Development Services Permitting Department
P 5[. 6nele County
Building and Code Regulation Division
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Commercial Residential
PERMIT TYPE: Remodel
PROPOSED IMPROVEMENT LOCATION:ff
Address: 9500 S Ocean Drive #1807 Jensen Beach, FL 34957
Property Tax ID #:4502- 2-0171-000-0
Site Plan Name:
Project Name:
DETAILED°DESCRIPTION OF WORK:
Remodel kitchen, build down ceiling to accomodate low profile ligl
switches, remove sink and faucet and replace
add under cabinet lid
CONSTRUCTION INFORMATION;
Additional work to be performed under this permit —check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters
Electric X Plumbing _Sprinklers _Generator
Total Sq. Ft of Construction: 300 Sq. Ft. of First Floor:
Cost of Construction: $ 15302.50 Utilities: —Sewer _Septic
Lot No.
Block No.
move 2 outlets and 3
Windows/Doors
Roof Pitch
Building Height:
OWNER%LESSEE:`
CONTRACTOR
14 ; -
NameAllan Sjoholm
Name Katherine LaDeene Dodson
Address:9500 S Ocean Drive #1807
Company:Agler Kitchen, Bath; & Floors, Inc
City: Jensen Beach State: _
Zip Code: 34957 Fax:
Phone No.772-777-347
Address:1970 NW Federal Hwy
City: Stuart State: FL
Zip Code: 34994 Fax:772-692-0070
Phone No772-692-0077
E-Mail:asjoholm@snet.net
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
E-Mail ladeene@aglerinteriors.com
State or County LicenseCBC1250637
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 CONSTRUCTI
LIEN LAW INFORMATION:
NEER: x
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: X Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: X Not Applicable
Address:
Zip:
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 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."
•-
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signature of Contractor -/License Holder
STATE OF FLORIDp�
STATE OF FLORIDA
COUNTY( `.��
COUNTY OF 5f L-uGf,
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
this � day of Occnember 20A by
this � day of PCCPmk" 20-ffl by
Name of person making statement.
Name of person making statement.
Personally Known K OR Produced Identification
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced
Produced
(Signature of Notai
Pa,p, I'[.
Signature oN
Commission No.
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Rev. 2///19