HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 1 I O
Date: �T— Permit Number: IA 12,;
o l
RECEIVELD --
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Building Permit Application DEC 0 5 2019
Planning and Development Services ST. Lucie County, Permitting
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982
Phone:(772)462-1553 Fax:(772)462-1578 Commercial X Residential
PERMIT APPLICATION FOR: Window/door
PROPOSED IMPROVEMENT LOCATION:
Address: 7380 S OCEAN DR 719, Jensen Beach, FL 34957
Legal Description: DUNE WALK BY THE OCEAN a/k/a SAND DOLLAR NORTH BLDG A UNIT 719
Property Tax ID#: 3522-607-0039-000-7 Lot No.
Site Plan Name: Block No.
Project Name: Dune Walk
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace windows and sliding glass doors with hurricane impact windows and sliding glass doors
-CONSTRUCTION INFORMATION-
Additional work toe nertormed under tispermit–check all that appy:
❑HVAC 0 Gas Tank Gas Piping _Shutters Q Windows/Doors
11 Electric E] Plumbing Sprinklers 11 Generator Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 13,800 Utilities:Sewer F Septic Building Height:
OWNERAESSEE: CONTRACTOR:
Name John Anthony Dziadul Jr Name: Janet Milici
Address:5600 Bella Terra CT Company: Natural Flow, Inc.
City: Wake Forest State:NC Address: 391 NE Baker Rd.
Zip Code: 27587 Fax: City: Stuart State:FL
Phone No.919-264-5758 Zip Code: 34994 Fax: 772-334-1078
E-Mail:Family1624@gmail.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 Milicl
Address:10800 S.Ocean Dr.,#303 Jensen Beach,FL 34957 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.
Sign ture of 0 ner/Lessee/Contractor as Agent for Owner Signat re of C ntractor/License Holder
STATE FLORIDA STATE OF FLORIDA
COUNTY OF m At-fI COUNTY OF M Alii f i
The forgoing instrument was acknowledged before me The forgoing instrument wa ac nowledged before me
thisday of WTCWI � ,201q by this_day of.N YYl E20_a by
JUe_+ PAi ILi
Name of person making statement Name of person making statement
Personally Known )C OR Produced Identification Personally Known YL OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Na Pu -Stat ture of No Pub Ic-State of Florida)
a}Isr"e Notary Public Stale of FI rida 7���
Commission No.a07$g 5 = headonna Jayne Hall Com ission No.P616,95,
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M. • My Commission GG 207 85 : try lic State of Florida
�lop Expires 04/15/2022 M � ' Donna Jayne Hall
_. My Commission GG 207585
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE ANG
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17