HomeMy WebLinkAboutBuilding Permit Application ALL APPLICA LE 1 FO MST IR ETED FOR APPLICAAN T BE ACCE TED
Date: .Permit Number:
L-GLO
Building PermitR'ppficatio%
Planning and Development Services 0
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 Phone: (772)462-1553 Fax: (772)462-157%Co4mo 12rciai X PAW _
PERMIT APPLICATION FOR: Window/door
Addr�s: 9650 S OCEAN DR 1407, JENSEN BEACH FL 34957
Legal Description: THE PRINCESS OF HUTCHINSON ISLAND UNIT 1407
Pr e 4502-610-0127-000-2 NO
Si�P an� c o.
Project Name: —
Setbacks Front— Back:—Right Sid eft Side.
49
Replace 2 sliding glass doors with 2 hurricane impact sliding glass doors
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply: - •
E1HVAC Gas Tank Gas Piping _Shutters Q Windows/Doors
� —Electric _Plumbing Sprinklers Generator Roof R tc
TooaSq.l J q�COstru i n: S . Ft JFi t FI• -
Cost of Construction:$ 19,000 Utilities: Sewer Septic Building Height.
OWNERAESSEE: R:
Name David Kielhurn 1 Name: Janet Milici
Address: 11 Vineyard WAY Mount Sinai Company: Natural Flow, Inc.
Cit�Mount Sinai State:NY Address: 391 NE Baker Rd.
Zip Code: 11766 Fax: Citf)Stuart State:FL
Phone No.631-786-9494 Zip Code: 34994 Fax: 772-334-1078
E-Mail:dkielhurn@aol.com Phone No. 772-334-1011
Fill in fee simple Title Holder on next a e 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. •
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: Not Applicable MORTG NotAnnlicable�
Name. _ _ Name:
Address: Addss:
City: State: Cityw State:
Zip: Phone Zip: Phone:
FEE SI E 9LE WD46: •_�p BONDNotApiwjw
Name: Name:
Address: Address:
City: City:
Zip: one: Zip: Phone:
OWNER/CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicate
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, nces, s, signs,scr n ro s cc sory es snot no -re ide tia use
&RNING TO OWNER: Your failure to 'Ord a Notif CIent mi rult inyig ticfor
improvements to your property. A Notice of Commencement must be recorded in the public recor s o 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 our Notice of Commencement*
Signature o Owner/ essee/Contractor as Agent for Ow ne Sig ture of ntractor/License Holder
STATEFL RID f • SATE OF FLORIDA
COUNTY OF in Aim COUNTY OF ko l� -
Sworn affirmed)and subscribed before me of Sworn to(or affirmed)and subscribed before me of*
Physical Presence or Online Notarization )I(_Physical Presence or Online Notarization
this '"day of II �F— , by_ this 3j:—day of M t(illLIA 24211 by _
�_VJA C'k ffi-Al; fzoZ< <�ayy—� ffl o t c:'w ""
Name of person statement. Name of person making statement. •
1111111,
Personally Known. Y�* OR Produced Identification— Personally Known OR Produced Identification
Type of Identification- Type of Identification - —
Produced Produced
(Signature of tar Pu -Stat urEof ta
.♦4 �"o otary Public State of Flori a
♦ Notary Public State of F no �
r nna Jayne Hall —�/��j 5 : 1% o a Jayne Hall
Commission No. 5�5 ( eaI Y Com Sion No. p�
• y Commission GG 20 585 +� s 04/1 12 22 2075 5
�Op M1o,*Expires 04/15/2022 • '♦a r�o��xP res 04/15/2022
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION$ SEA TURTLE, MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE 000 � 0
RECEIVED
DATE
COMPLETED 0 M
Rev. 5/6/2049
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