HomeMy WebLinkAboutBUILDING PERMIT APPLICATION HershornALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
COUNTY
F L 0 R I 0 A
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: 9940 S OCEAN DR 1105, JENSEN BEACH, FL 34957
Legal Description:
OCEANA OCEANFRONT CONDOMINIUM ONE APT 1105 AND .7120 PERCENT INTIN COMMON ELEMENTS
Property Tax ID #: 4502-502-0112-000-2 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Replace entry door with hurricane impact entry door
' RUCTION INFORMATION
A • itional
HVAC
work to bertormed under
Gas Tank
this permit - check all
Gas Piping
-ha t1 apply:
IShutters [LI Windows/Doors
[1 Electric Plumbing Sprinklers Generator - - Roof Roof pitch
Total Sq. Ft of Construction: S9. Ft. of First Floor:
Cost of Construction: $ 1,850 Utilities: I Sewer Building Height: -Septic
OWNER/LESSEE: CONTRACTOR:
Name Joyce Hershorn Michael Hershorn Name: Janet Milici
Address: 22024 Las Brisas CIR Company: Natural Flow, Inc.
City: Boca Raton State: FL Address: 391 NE Baker Rd.
Zip Code: 33433 Fax: City: Stuart State: FL
Phone No. Zip Code: 3499 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@naturaffl0w.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.
Phone:
Address:
City:
Zip:
2-O2( c-- Wit
c-
x OR Produced Identification
re of Na ary ub St
sion No.
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY:
Name:
Not Applicable
Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER:
Name:
Not Applicable - BONDING COMPANY:
Name:
Not Applicable
Address:
City:
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 your Notice of Commencement.
Sig ature of ntractor/License Holder
(LQ
Signatireof'er/ Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF t4Ai2,II t-J
STATE OF FLORIDA. I COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Physical Presence or Online Notarization
thi ,-O-by
2.02-I
Name of person making statement.
Personally Known X OR Produced Identification
Type of Identification
Produced
Sworn to (or affirmed) and subscribed before me of
$ Ph4icaI Presence or Online Notarization
this24 day of c1)C ,
Name of person making statement.
Type of Identification
Produced
Personally Known
Sig ature of NMI ublitk State
ComkTiission No.
Qrf5' 5 •
'
Notary Public State of Florida
faIbonna Jayne Halt Com
.. j
My Commission GG 207585
xprei 0411512022
Q4 Not Public State of Florida
a ' (i.R*ia Jayne Hall
. My Commission GO 20758 5
Expires 0411512022 10
REVIEWS FRONT
COUNTER
ZONING
REVIEW
SUPERVISOR
REVIEW
PLANS
REVIEW
VEGETATION
REVIEW
SEA TURTLE
REVIEW
MANGROVE
REVIEW
DATE
RECEIVED
DATE
COMPLETED
ev. 5/6/20
t&nc+