HomeMy WebLinkAboutAPPLICATION Hazen'AP AP P
Date:
OCTONI-Fi;
ermit Number:
_... _ iIdi P t t i?A pIic4tti�
Planning and Development Services
Building and Code Regulation Division_
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-15789 Commercial X Residential*
PERMIT APPLICATION FOR*Window/door
PROPOSED IMPROVEMENT LOCATION:
Address: 8750 S OCEAN DR PH-51, JENSEN BEACH, FL 34997
Lea D• ription: ISLAND DUNES CONDOMINIUM A UNIT PH-51 A/K/A ADMIRAL CONDOMINIUM (OR 3390-2321)
memo 111M�
Property Tax ID #: 3535-601-0105-000- Lot No.
Sit PI N e:* Block No.
t�0 10,
Setbacks Front Back: Right Side: Left Side:
DET�IL_ED DESCRIPTION OF WORK:
Orac s I Ing glass cloors I h I ct M In g a
NSTRUCTION INFORMATION:
Additional work to be nertorme un er t is Pmi4 c eck afl apply: • •
AHVAC Gas Tank AGas Piping Shutters Q Windows/Door
ct�c ❑ bifTg S�r 7 I � Roof itch
i � iii��
Total Sq. Ft of Construction: S . Ft. of First Floor: _
Cpf Cons r c i 38,800 7 oU '�. S=A t i 9 H 21 ht:-
DOWNER/LESSEE:
CONTRACTOR: --------
Name Susan Hazen
Name: Janet Miiici
Address: 23 White Oak C
Company: Natural Flow, Inc.
City: Corame State: NY
Address: 391 NE Baker R
Zip Code: 11727 _ Fa-.--
City: Stuart is State: FL_
Phone No. 772-807-1914
Zip Code: 34994 —Fax: 772-334-107840
E-Mail: Safntrim24@aol.com
Fill in fee simple Title Holder on next page ( if different
Phone No. 772-334-1011 -
E-Mail: Janet@naturalflow.net 0 - _
State or County License: SCC 131151263
from the Owner listed above) 0 M /
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNS
Name:
Address:
City: —
Zip:
• •
Not Applicable ilp
State:
Phone �—
�0
MORTGAGE CONY: !_ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: 40 Not Applicable I BONDING COMPANY: 40 Not Applicable
Name:
Address:
City:
Zip: Phone:
Name:_
Address:
City:_
Zip:
Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I cert th no work or installation has com enced prior to the is uanof a er�mi`
�t. L e C n12t"awetsh
esno represen a to th rs nti a perms ill'3Citho zPf c f1�e permit holder to build thiRbjlt stfct e
which is in con any applicable Home Owners Association rules, bylaws or and covenants that may restrict or pro it 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 to approv plans, the Florida Building Codes and St. Lucie County Amendments
The following builds permit Irplications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools nces, walls, signs, s#(Eroo�cce�ry use* anoth n-residbtia use7111111110
WARNING TO OWNER: Your failure to Record a Notice to
of Commencement may result in paying twice for* is
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 your Notice of Commencement.
Signal re of Ow cr/ Lessee/Contractor as Agent for Owner • ATE
ture of ntractor/License Holder
P40• OF FLOR� • i OF FL9"
COUNTY OF COUNTY OF
Sworn to (or affirmed) and subscribed before me of Sworn to or affirmed) and subscribed be ore me o
Physical Presence or Online Notarization Y �P��sical Presence/ or Online Notarization
this _�ay of OMA i62by _ this R- day of ►TIlF) , 2&Mby •
-r� Lo z I Gov Z I
Name of person making statement. Name of person making statement._
Personally Known C OR Pro ucWent, Otcatio,ersona y no wn o c d I
Type of Identification - Type of Identification
Produced Produced
• • C r� go^
Sig ature of N tart' ubIi State i re of N art' Pub St I
"��etary Public State
Comrniss�5 No. c7�FlV! (/ 00 i' onna Jayne Ha%l
r < My Commission GC
� 71-4�xpres04115/2022
7 ��, •�q Not Public State of
/ F a Jayne Hall I
My Commission GG 2
11io41111IExpires 04115/2022
RE I FRONT • ZONING��,,ISWREVIEW141111�0'
PERVISOPLANAI VEGETATION 7EATURTLE MANGROVE
COUNTER REVIEVUREVIEW SREVIEW- VIEVO REVIEW
DATE
REC RD -� - - - -
CO DATE
PLETED • • — I I —�- •
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