HomeMy WebLinkAboutBuilding permit applicationALL 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
Address: 10200 S Ocean DR # PH-5 Jensen Beach, FL 34957
Legal Description: ATLANTIS III BY THE SEA UNIT PH5(705) AND PRO-RATA SHARE IN COMMONELEMENTS (OR 637-2888: 597-2598)
Property Tax ID #: 4511-518-0063-000-0
Site Plan Name:
Project Name:
Lot No.
Block No.
Setbacks Front Back: Right Side: Left Side:
Replace 1 sliding glass door with 1 hurricane impact sliding glass door
❑HVAC
❑ Electric
F]Sprinklers
"Shutters
ElPlumbing M Generator Roof Roof pitch
Total Sq. Ft of Construction:
Cost of Construction: $ 4,600
S Ft. of First Floor: _
Utilities:DSewer OSeptic
Name Ron Mosca
Address: 10200 S Ocean DR # PH-5
City: Jensen Beach State: FL
Zip Code: 34957 Fax:
Phone No.
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
QWindows/Doors
Building Height:
Name: Janet Milici
Company: Natural Flow, Inc.
Address: 391 NE Baker Rd.
City: Stuart State. FL
Zip Code: 34994 Fax: 772-334-1078
Phone No. 772-334-1011
E-Mail: Janet@naturalflow.net
State or County License: SCC 131151263
IT value of construction is 5Z500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: _ Not Applicable
Name:
MORTGAGE COMPANY: _ Not Applicable
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."
Signature Owner/ ssee/Contractor as Agent for Owner Sign ure of Cont actor/License Holder
STATE
COUNTOY' �t OF DA I II—, N COUNTY OF STA RIDA
The forgoing instr}�ment was acknowledged before me The f rjoing instr ment was acknowledged before me
thisday of J�Q. 20 ZO by this day of 3 20� by
Name of person making statement. Name of person making statement.
I
J
Personally Known _)(— OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
1 lU
(Signature of Not��11 y P blicc- tate of Florida) (Si nature of Nota S to of Florida )
/1Pu)ic-
Donna Jayne Hall �ublic State of Florid
Commission GG 20758 a Jayne Hall
_ -- _pugsDgti�L292z — mmission GG 207585
OF 1�s D�i7T57Z0Z2---
Commission No. O�V7 5 D "'6 (g`� y Public State of Florid Co mission No. V7 5WREVIE
REVIEWS FRONT O NG PERVISOR PLANS I VEGETATION
COUNTER REVIEW REVIEW REVIEW REVIEWREVIEW
DATE
RECEIVED
DATE
COMPLETED—
- - -- .._... - - - - ----.. -- - - - - - - - ------�-----------