HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
`' . _i
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: 9500 S Ocean DR Apt 201 Jensen Beach, FL 34957
Legal Description: ISLANDIA II CONDOMINIUM UNIT 201 (OR 3699-94)
Property Tax ID#: 4502-602-0005-000-6 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
•,
Replace front entry door with hurricane impact front entry door
gill gli
11
Additional work tc e e ormed un der this permit—ChecK all thal apply:
11 F]Gas Tank ❑Gas Piping _Shutters Windows/Doors
❑Electric ❑ Plumbing Sprinklers Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ 1,700 Utilities:Sewer 0Septic Building Height:
Name Angel Almanzar Name: Janet Milici
Address:9500 S Ocean DR Apt 201 Company: Natural Flow, Inc.
City: Jensen Beach State:FL Address: 391 NE Baker Rd.
Zip Code: 34957 Fax: City: Stuart State:FL
Phone No.954-444-1675 Zip Code: 34994 Fax: 772-334-1078
E-Mail: 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.
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 paying twice for
improvements to your property. A Notice of Commencement must be recorded in the public records of St.
Lucie County 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 a Notice of Commencement.
Signat k
of Ow er/Lessee/Contractor as Agent for Owner Si nature Contractor/License Holder
COUNTYOF STATEORIDA �/� .-� COUNTY OFSTATE OF ORIDA M
Sworn to(or affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of
x Physical Pre5ence or Online Notarization N Physical Pr sence or Online Notarization
this day of 2020 by this�day ofDI9C�&94 2020 by
Ill 3lme,+ ("i t i Ll,
Name of person making statement. Name of person making statement.
Personally Known X OR Produced Identification Personally Known 1�in OR Produced Identification
Type of identification Type of Identification
Produced Produced
(Signature of Nota Pu ic- to of Fra i n t r of Not Pu ic Sk011
-
Notry Pubtie State of FI i7/� c��5uiatti•Pwobc Sta a Fbtida Z� 5 SUv v �t ? na Jayne Hall
Commission No D�.t�ria Ja ne H II ommissio No �Y y ommission GG 207 8y Commission G 207585 �'��n Expires 04/15/2022
xpires 04/15/20 2
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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