HomeMy WebLinkAboutAPPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Permit Number:
Date:
•
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 Residential
PERMIT APPLICATION FOR: Window/door
PROPOSED IMPROVEMENT LOCATION:
Address: 8750 S. Ocean Dr., #1031 Jensen Beach, FL 34957
Legal Description: Island Dunes Condo A, Unit 1031 a.k.a. Admiral Condo
Property Tax ID #: 3535-601-0049-000-2
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side
Left Side:
Lot No._
Block No.
DETAILED DESCRIPTION OF WORK: I
Replace sliding glass doors with hurricane impact sliding glass doors
CONSTRUCTION INFORMATION:
Additional work to be nertormed under this permit — check an apply:
❑_ HVAC Gas Tank ❑Gas Piping _ Shutters Q Windows/Doors
❑ Electric ❑ Plumbing ❑ Sprinklers ❑ Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 61,890
Sc.t. of First Floor:
Utilities:InSewer ❑Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name David Jubanowsky
Name: Janet Milid
Address: 8750 S. Ocean Dr. #1031
Company: Natural Flow, Inc.
City: Jensen Beach State: FL
Zip Code: 34957 Fax:
Phone No.
Address: 391 NE Baker Rd.
City: Stuart State: FL
Zip Code: 34994 Fax: 772-334-1078
Phone No. 772-334-1011
E -Mail: Jubanowskyd@bellsouth.net
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: Janet@naturalflow.net
State or County License: SCC 131151263
If value of construction is 52500 or more, a KtLUKUtU NOLICe OT lOmmenLernent lb I cyuu cu.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
Address:
City: State:
Zip: Phone
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
Name:
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
_
Address:
_
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 thepermit 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."
Rev. 2/7/19
Signature f Own / Lessee/Contractor as Agent for Owner
Signatre of Co ractor/License Holder
STATE OF FLORIDA
STAT FLORIDA
OF hh
COUNTY OF jL(,�r'I'7 I°1
COUNTY
The foxing instr ent was acknowledged before me
The for instrument was acknowledged before me
this a-- day of �J _, 207_0 by
this day of FP (JI'yG�i'1 202
=0 by
� (I GI
1 ✓� � � I I � c, f
t -� y1 -� i
Name of person making statement.
Name of person making statement.
Personally Known (in- OR Produced Identification _—_
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced _
Produced____
ALU
i
(Signature of tar Pu - S ate o Flori a
nature of Notar lic at
n y "a of Public State of Florid
Commission No. 6 158 �� ( Aa Jayne Hall
c/ dyr N y Public State of FI'
Co mission No. 5J 5 ;* SeWna Jayne Hall
nay Comm ssion GG 207595
j E,paei 04/1 51202 2
"3 ` MY Commission GG 207
ry Expires 0411612022
REVIEWS
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VEGETATION
SEA TURTLE
MANGROVE
COUNTER
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REVIEW
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Rev. 2/7/19