HomeMy WebLinkAboutAPPLICATIONALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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 1231, Jensen Beach, FL 34950
Legal Description: ISLAND DUNES CONDOMINIUM A UNIT 1231 A/K/A ADMIRAL CONDOMINIUM (OR 3823-1381)
Property Tax ID #: 3535-601-0061-000-2
Site Plan Name:
Project Name:
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Right Side: Left Side:
Replace sliding glass doors with hurricane impact sliding glass doors
CONSTRUCTION INFORMATION:
Lot No.
Block No.
Additional work to be nertormed under this permit — check all apply:
OHVAC LJj Gas Tank ❑Gas Piping Shutters Q Windows/Doors
❑ Electric ❑ Plumbing 11 Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: _
Cost of Construction: $ 54,000
So. Ft. of First Floor:
Utilities: Sewer Septic Building Height:
OWNER/LESSEE: ::T
CONTRACTOR:
Name Donna Lake
Name: Janet Milici
Address: 312 N Grover N AVE
Company: Natural Flow, Inc.
City: 312 N Grover N AVE Massapequa Park State: NY
Zip Code: 11762 Fax:
Phone No. 772-229-2077
Address: 391 NE Baker Rd.
City: Stuart State: FL
Zip Code: 34994 Fax: 772-334-1078
Phone No. 772-334-1011
E-Mail:
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 KtCUKutu Notice or Lommencemem is requires.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER:
— Not Applicable
MORTGAGE COMPANY: _ Not Applicable
Name:
Name:
Address:
Address:
City:
State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
_ Not Applicable
BONDING COMPANY: Not Applicable
Name:
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 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 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."
Signa ure o/Ow er/ Lessee/Contractor as Agent for Owner
Signature of Contr ctor/License Holder
STATE RIDA
STATE OF FLORIDA
COUNTY OF N1 OTI �J _
COUNTY
The forgoing instr ent was acknowledged before me
this LIday of �U(� _, 20 20 by
The forgoing instrument was acknowledged before me
this day of F?4prv�:� , 20 Z0 by
-,3 0_fA
c:(
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___
1 I A�d.�
(Signature of No r Pub' - State of Florida
(Signature of Not a P blic ate of Florida )
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No.
Commission No. •w Norary00blic State of Florida
+ Donna Jayne Halltate
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COUNTER REVIEW REVIEW
REVIEW REVIEW
DATE
RECEIVED
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DATE
COMPLETED
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Rev. 2///19