HomeMy WebLinkAboutapplicationALL APPLICABLE INFO
pMUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED y ��
Date: 7 1 - \S �� Permit Number:
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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 X
PERMIT APPLICATION FOR: Renovation
PROPOSED IMPROVEMENT LOCATION:
Address: 9650 S. OCEAN DRIVE, JENSEN BEACH, FL 34957
Legal Description: THE PRINCESS OF HUTCHINSON ISLAND UNIT2002-
DEC 0 3 2019
ST. Lucie County, Permitting
Property Tax ID #: 4502-610-0182-000-5 Lot No.
Site Plan Name: Block No.
Project Name: JACKSON CONDO REMODEL —
Setbacks Front Back: Right Side: Left Side:
I DETAILED DESCRIPTION OF WORK: 1 $" 1
MASTER BATHROOM RENOVATIONgND KITCHEN RENOVATION, SOME ELECTRICAL TO BE
ATTACHED,./e��,�-G Bq p,�,uvt�lon�
lY
I CONSTRUCTION INFORMATION: I I III
1_]HVAC U Gas Tank
❑✓—Electric ❑✓_Plumbing
Total Sq. Ft of Construction: 600
Cost of Construction: $ 17,000.00
Jen IIII—do dppry:
aas Piping _Shutters Windows/Doors
Sprinklers 1:1 Generator Roof = Roof pitch
S . FtFt. of First Floor: 1208
Util ities: Sewer []Septic
Building Height: 300
OWNER/LESSEE:
CONTRACTOR:',
i
Name DAVID JACKSON
Name: RICHARD P DUFFIELD
Address:9650 S. OCEAN DRIVE
Company: SUNSTATE CONTRACTORS LLC
City: JENSEN BEACH State: FL
Zip Code: 34957 Fax:
Phone No.214-361-4500
Address: 2697 SW DOMINA ROAD
City: PORT ST LUCIE State: FL
Zip Code: 34953 Fax: 772-264-6439
Phone No. 772-224-2793
E-Mail: DAVIDJ058@GMAIL.COM
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail: RICKY@SUNSTATECONTRACTORS.COM
State or County License: CBC-1261719
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION: 1,
DESIGNER/ENGINEER: x Not Applicable I MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: -Phone
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: ! Not Applicable
Name: Name:
Address: I 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 Count 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
commencing work or re9diw—Vour Notice of Commencement.
51
nature of Owner/ Less ntractor as Agent for Owner
Signatkze��
ure of Contractor/Lic se older
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COUNTY
ATE OF FLORIDA
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STATE OF FLORIDA /
COUNTY OF
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e forgoing instrument wasacknowledged before me
s day of �J�yo V , 20 by
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The forgoing instrument was acknowledged before me
this day of 20�by
IC iLharO IP�cY
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Name of person making statement
rsonally Known OR Produced Identification
Name of person making statement
Personally Known OR Produced Identification
T
pe of Identification
Type of Identification
=P
oduced
Produced Q
(Signature of Notary Public- State of Florida j
(Signature oMota4 Public -State of Florida )
Commission No. LR: (Seal)
Commission No.S��dk��'7'7 (Seal)
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
i
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17