HomeMy WebLinkAboutAPPLICATION Permit Scan KoertnerL� la ri BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -16- 1 Permit Number:
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B.0 ildinMRRIA 11ti n
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Planning and Development Services
Building and Code Regulation Divisions
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-15780 Commercial X Residential
PERMIT APPLICATION FOR-Window/door
PROPOSED IMPROVEMENT LWATION:
Addrest*8880 S Ocean DR Apt 1010 Jensen Beach, FL 34957
Legal Description: ISLAND DUNES OCEANSIDE CONDOMINIUM I UNIT 1010 (OR 3185-2924)
Propert Tax ID #: 3535-602-0092-000-1 of No—
_
R1Pe:* _ Bck No.
®rojtecam7pe:KOERTNER —
Setbacks Front 0 M Back: � ORight Side 1111=111 Left Side
L,DETAILED DESCRIPTION OF WORK: J
Rep ace 4 win ows and b s I ing glass doors wittl 4 flurricane impaCT windows and s I in g ass
doors
I
CONSTRUCTION INFORMATION:
Additional work to b
jertormed under this permit - check a
�HVAC L�J Gas Tank Gas Piping
apply: �• • -
Shutters Windows/Doors
•
�a � eTc�c ❑� m in �S�rin <Tf�s ,
— .
❑ ene afor �� off � �f itch
Total Sq. Ft of Construction: S .
Ct o� Cuc n: 69,430 . •�
Ft. of First Floor:
SP-� � HP�
_ _-
OWNER/LESSEE:
CONTRACTOR:
Name Camille Koertner
Name: Janet Milici
Company: Natural Flow, Inc.
Address: 8880 S Ocean DR Apt 1010 Jensen Beach, FL 34957
City: Jensen Beach 0 410 State: FL
Address: 391 NE Baker Rd.
Zip Code: 34957 - Fax:
City: Stuart State: FL*
Phone No. 847-452-055940 _
Zip Code: 34994 -Fax: 772-334-107840M
E-Mail: Camille. koertner@gmail.co
Phone No. 772-334-1011
E-Mail: Janet@naturalflow.net
_
Fill in fee simple Title Holder on next page ( if different
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. ,
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DESIGNER/ENGINEER:
_ Not Applicable
MORTGAGE COMPANY:
_ Not Applicable
Name:
Name:
Address:
City:•
Zip: Phone
•
State:
•
Address:
City!
Zip: Phone:
18
State:
FEE SIMPLE TITLE HOLDER:
_Not Applicable icable
BONDING ANY:
_Not Ap licable
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.
ifertify 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 t e 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, p rform the k
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 a itions,
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 S .
• Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consu
with lender or an attornev before commencing work or recording your Notice of Commencement.
Signatur of Own / Lessee/Contractor as Agent for Owner Sign a �Co ractor/License Holder
STATE O ORIDA • ,11 STATE OF FLORIDA • n• + `
COUNTY OFCOUNTY OF6tT�—, N •
Sworn to (or affirmed) and subscribed before me of — Sworn to (or affirmed) and subscribed before me of
yslcal Presence or _— Online Notarization Physical Presence or*_ Online Notarization
this(( day of /01 2TZU' by this day of n(�gQ,C.*r4 482� by
• l (mot ,Z021 &Ae---S ('V1► I I;
Name of person making statement. Name of p4on mak g s ".
Personally Known _ OR Produced Identification- Personally Known OR Produced Identification
Type of Identification Type of Idefica� •
Produced Produced
(Signature of
of Florida
Commission No.� 169 rU , 'y�Se�b aryPubhcState
- • nna Jayne Hall
My Commission GG
__ , n4i1&2022
a
REVIEWS FRONT • G• SUPERVISC
— COUNTER REVIEW REVIEW
DATE
RECEIVED • • • • •
DATE
COMPLETED •
•
ature of Notary c- St e 0 arlotary Public State of
�rlr/ cG 5 ,ice Donna Jayne Hall
nission No. V ((J D 9")xnmission GG 2
- jyr xpxpaes 04/15/2022,
)R PLANS VEGETATION SEA TURTL MANGROVE
REVIEW REVIEW •REVIEW REVIEW
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