HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST.BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number: CQ 0a 0,-f�_g
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 Residiential.
PERMIT APPLICATION FOR: Demolition
PROPOSED IMPROVEMENT LOCATIN:
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Address: 9500 South Ocean Drive, Unit 1:503,Jensen Beach, FL 34957
Legal Description: Islandia II Condominium Unit 1503 (OR 3819-834, 836)
Property Tax ID#: 4502-602-0137-000-0 Lot No.
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Site Plan Name: Block No.
Project Name: Blotnick residence
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION`0F WORK:
Demolition of interior non-structural framing and drywall for future interior renovation. Areas include
bathrooms, kitchen, and bedroom walls
CONSTRUCTION INFORMATION.
Additiorial work to be nertormed un e_r t is permit—check all h appy:
❑HVAC Gas Tank Gas Piping Shutters Windows Doors
❑ P ❑ /
EJElectric❑ Plumbing Sprinklers ❑Generator ❑ Roof
Total Sq. Ft of Construction: S . Ft.of First Floor:
Cost of Construction:$ 2 000 Utilities: zSewerSeptic I Building Height: .
OW.N ERAESSEE: CONTRACTOR:
Name David Blotnick Name: Paul L Kleinfeld
Address: 9500 S Ocean Drive, Unit 1503 Company: First Florida Development&Construction Inc
City. Jensen Beach State: FL Address: -200 NE Dixie Highway
Zip Code: 3.4.957 Fax:, City: Stuart I State::FL
Phone No. 561.662.9989 Zip Code: -34994 Fax: 772.692.2359
E-Mail: davidb@consultpr.net Phone No: 772.692.2359
Fill in fee simple Title Holder on next page(if different E-Mail: cindi@firstfloridaincJcom
from the Owner listed above) State or County License: CGCA20468
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: xx Not Applicable MORTGAGE COMPANY:.! xx Not Applicable
Name:
Charles - Name:
Address:632 east Drive Address: II
City: Delray Beach State: FL City: State:
Zip: 33445 Phone: 561.239.1708 Zip: Phone:
1,
FEE SIMPLE TITLE HOLDER::' xx Not Applicable BONDING COMPANY: xx Not.Applicable'
Name: Name:
Address: Address:
City: City: .
Zip: Phone: Zip: Phone:
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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 1 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 Commend st be recorded and posted on the jobsite.
before the first inspection. If you intend to.obtain fin ncing, ns.ult with lend ;r an attorney before
commencingwork or.re ordin our Notice of Comergent.
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Signature of Owner/Lessee/Agent _ Signature of Contractor/License of er
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Marin COUNTY OF Martin
The forgoing instrument was acknowledged before me The forgoing instrumen was acknowledged before me
this Z& -day of aI' 20/4 by this�day of- 20 fR by-
David Slotnick/Omer Paul L Kleinfeld,President/Qualifier li
(Name of person acknowledging) (Name of person acknowledging)
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(Signawfe of Notary Public-State of FI rida) (Signat e of Notary Public-State of Flo da)
Personally Known.xxxxx OR Produced Identification Personally Known xxxxx OR'Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. W%s
yNTI&A T�INI(hTG Commission No. eaCYNTHIA D." G
Y COMMISSION#FF921123 MY COMMISSION#FF921123
FXPIRE8: 23
,2019 A
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE.
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW.
DATE
COMPLETE
INITIALS t
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