HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED (�
Date: Permit Number: c is
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Building Permit Applicatio
Planning and Development Services sBuilding and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 ty, Nermwe,,c,
Phone:(772)462-1553 Fax:(772)462-1578 Commercial X Resl en la
PERMIT APPLICATION FOR: Window/door
PROPOSED IMPROVEMENT LOCATION:
Address: 9940 S OCEAN DR 707,Jensen Beach, FL 34957
Legal Description: OCEANA OCEANFRONT CONDOMINIUM ONE APT 707 AND.7875 PERCENT INT IN COMMON ELEMENTS(OR 1492-1928)
Property Tax ID#: 4502-502-0074-000-3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace sliding glass door with hurricane impact sliding glass door
CONSTRUCTION INFORMATION:
Additional work toe nertormed under tispermit—check all that appy:
HVAC Gas Tank ❑Gas Piping _Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers E Generator 1:1 Roof Roof pitch
Total Sq. Ft of Construction: Sq. Ft.of First Floor:
Cost of Construction:$ 6,900 Utilities:Ind Sewer E]Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Richard Wegman Name: Janet Milici
Address:PO Box 590 Company: Natural Flow, Inc.
City: Ephraim State:WI Address: 391 NE Baker Rd.
Zip Code: 54211 Fax: City: Stuart State:FL
Phone No.920-883-8444 Zip Code: 34994 Fax: 772-3341078
E-Mail:celestewegman@yahoo.com Phone No. 772-334-1011
Fill in fee simple Title Holder on next page(if different E-Mail: Janet@naturalflow.net
from the Owner listed above) State or County License: SCC 131151263
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:Janet Millcl
Address: Address:
City: State: City: Stuart State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:391 NE Baker Rd. 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 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
commencing work or recording our Notice of Commencement.
Sig ature of er/Lessee/Contractor as Agent for Owner Signatur of Co ractor/License Holder
STATE FLORIDA STATE OF FLORIDA /
COUNTY OF M.A4:0 lJ COUNTY OF �1 N
The forging instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 36 day of t(M.394 ------.?20J by thisday of f 6n l'LIQ- ,20A by
.-kae-4 I V ( c -ii o 1 1 1 L i
Name of person making statement Name of person making statement
Personally Known�OR Produced Identification Personally Known X OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of No ry ubll -State of Florida) (Signature of No ry ubll State of Florida)
Commission No. ••7 KIM 91ic State of Florida Commission No. (Seal)
1fi ��5 I Donna Jayne Hall
�J My Commission GG 207585 �sr�c� Notary Public State of Florida
Oy c� Expires 0411512022 + `F Donna Jayne Hall
My Commissii n 2
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATI ? ' ' 4/1522 A
COUNTER REVIEW REVIEW REVIEW REVIEW I
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17