HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONPLI
Date: Permit Number:
- J'= 1
•
• BOHAI MAR ARIPatioR
Planning and Development Services
Building and Code Regulation Division
300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578 commercial X residential
I,XERMIT APILICATION,LOR: Window/door A
C.PROPOSED IMPROV,FMFNT. I Q jjj ..„>_,
Address* 0680 S Ocean Dr #303 Jensen Beach, FL 34957
" DIP rip ion:
ISLAND CREST CONDOMINIUM UNIT 303 AND UNDIV SHARE IN COMMON ELEMENTS (OR 3269-2671)
Property Tax ID #: 4511-516-0030-000-4 Lot No._
pl4ce 2 ng gl 2 Ic
p ct g 94" '
dditi��I worK to be err uncl tnis pe — ecK all a i
�HVAC as ank� Gas aping S utters a Windows/D-
ElectricAk ElPlumbing US rinklers ❑� Generator ' Roof , Roof pitch
Total Sq. Ft of Construction: S�Ft. of First Floor:
Cost of Construction: 15,290 Utilities: I �I Sewer IC Se ti�Buildin�Height—
OWNER/LESSEE: -',.
CONTRACTOR:
Name Angelika T Tsuda
Name: Janet Milici
Company: Natural Flow, In
Address: 391 NE Baker Rd.
City: Stuart State: FL
Zip Code: 349940 Fax: 772-334-1078
Phone No. 772-334-1011
Address: 10680 S Ocean Dr #303
City- Jensen Beach tate: FL-
Zip Code: 349570 —Fax:—
Phone No. 786-683-2856
E-Mail: Tat0807@gmaii.com
ee simpleWold�n next page ( if different
from the Owner il above)
Eai ' Janet@naturalflow.net
Stye or County License: SCC 131151263
Ivalue of construction is $2500 or more, a C DED Notice of Co encemet is requgd. II
DESIGN/1EFj. 4010_ itipiiiip MORTGAGE COMPANY:�=,Not Applicable
Name: Name:
Address: Address:
City: S City: S
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _ Not Applicable BONDING COMPANY: Not Applicable
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.
I ceLLify that no work or installation has om*nritpthe iss an o a p rm� J
St'[LiZTe Coun mTo re resen a thin erml III th�riz�th ermit holder to build t sub ect structur
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit suc
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 approv d pla s, th Florida Building Codes and Lucie County Amend ts.
Th9folltingbVid Permit�plicCAreteA from undergoin full concurren"vie oom additions, —
accessory structures, swimming pools, fences, walls, signs, screen roofs and accessory uses to anothe6on-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 our Notice of Commencement.
Signaturf of Own / Lessee/Contractor as Agent for Owner I Signatu e of Co ractor/License Holder
T�O OR '* • • -' I ATE OF FL D • •
COUNTY OF I�I�x-�� (� COUNTY OF �AI
Sworn to (or affirmed) and subscribed before me of Sworn to or afirmed) and su scribed e ore me o
Physical Presence or Online Notarization ,X Physical Presence or Online Notarization
thim s day of WICC-IMVIL �O2 by_ this ' day f aCCan(3EV_ �by -
1�1UJ��'i"�I'Y��ItLj�2�_
Name of person making statement.& AL Name of person making statement..
Personally Known _� 0 Produced entl "Ica , Persona y nown x • O rimed I111#r Ic
ton
Type of Identification_ • • Type of Identification
Produced Produced /I '' •• ,,,,
I )rX_1 ft et-�44 040 !AM � W