HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONI
%RLPORA INIF T BE CIRI Ej
Date: Permit Number.
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Building Permit �AMication
Planning and Development Services 9 0 am*
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 409 Jensen Beach, FL 34957
LegafDescription: ISLANDIA II CONDOMINIUM UNIT 409
Property Tax ID #: 4502-602-0033-000-1 Lot No-
!7R: -
Sit?Octa
Projeme:
Setbacks Front — Back: _ Right Side:— Left Side: 0 0 00000
DETAILED DESCRIPTION OF WORK:
ep ace front entry door witti a nurricane impact front entry door
CONSTRUCTION INF ; N:
Additional work to be De orme under this permit — check a apply: •
AHVAC 40 Gas Tank F61Gas Piping Shutters Windows/Doors
I1 _
Aec ❑ P �Sep , Genera or of f
ric um ing riMers pitch
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—
Total Sq. Ft of Construction: S . Ft. of First Floor:
1,700
Cost of Co ction: i ities:� Sew_ Septi(uil ng W
WNER/LESSEE: '
CONTRACTOR:,
Name Charles S Milliken
Name: Janet Milid
Address: 9500 S Ocean DR Apt 409
Company: Natural Flow, Inc.
Address: 391 NE Baker Rd.
CitALIensen Beach State: FL
Zip Code: 34957 Fax:
City: Stuart _ _ State: FLU
Phone No. 772-229-120840 _
Zip Code: 34994 —_ Fax: 772-334-1078_
E-Mail: cdmilliken@comcast.net
Phone No. 772-334-1011
Fill in fee simple Title Holder on next page ( if different
E-Mail: Janet@naturalflow.net
State or County License: SCC 131151263
from the Owner listed above)
If value of construction is $2500 or more, a RECORDED Notice of commencement is required.
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DESIG"ERGINEER•
Name.
Not Applicable
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MORTGAGE COMPANY: _Not Applicable
Name:
Address:
City:
Zip: Phone
State:
�•
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
_ Not Applicable
BONDING COMPANY: Not Applicable
Name: i
Address:
City:
Address:
City:
Zip: Phone:
Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
4ter f tha —workor installation has commencedprsua a pt
t. LZ7C COT a es no representation that is granting a perms will aut orize die permit o er to ui d t e su ject structure
which is in confflict 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.
4 consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, Vrf e
n accord e �th th pro pl��ns, t I da Builds *Oego
a�St.Luci Cour�y �eents.
�he folio g b Idin ermi pliZation are tempt fr i�ig a full c�ncurrency 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, caul
with lender or an attorney before commencing work or recording our Notice of Commencement.
Signabr of Own ,4ssee/Contractor as Agent for
OUNTY OFSTATE d ORID�m�n�f
Sworn to (or affirmed) and subscribed before me of,
Physical Presence or"Online Notarization
this Wday of HA I L W75 by
il=IPam+ >n/� ►1 • zo
Name of person making statement.
Personally Known �� OR Produced Identification
Type of Ide tification • —
Produced � •
(Signature of Not ray IVibli�State of Florida )
Commission No. �/ 1 VYxS�Q�ary Public State,
tInana Jayne Hall
1: a My Commission^GG
REVIEWS FRONT FZGMNIG SUPERVIS
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DATE
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STATE OF FLORIDA
COUP InAI
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
this � day of I L— by
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Name of person making statement
Personally KnownL_ OR Produced Identification
Type of Identification_
Produced
Si nature of tar Put&- St a o�F ridaAwary Public State of Flc
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manna Jayne Hall
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