HomeMy WebLinkAboutBUILDING PERMIT APPLICATION S TEMPFORMPMAIA01ACEPTED
Date: • Permit Number:
,Buildin Peer it Appli'McRi
F3000rginia
Development Services
Code Regulation Division -
Avenue, Fort Pierce FL 34982
)462-1553 Fax: (772)462-1578 ,COm ercial Residential
4jERMIT AP4jLICATION40R: Window/door Ah
Address: 8880 S Ocean Dr#1405 Jensen Beach, FL 34957
ega ascription: ISLAND DUNES OCEANSIDE CONDOMINIUM I UNIT 1405 (PH 5)(OR 1575-2866)
Property Tax ID#: 3535-602-0127-000-6 Lot N ._
Site PI1RName-* Block No.
=o :
Setbacks Front_ Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
eK place 2 winclows, slicling glass cloors ana 5 vxecl winclows witn 2 wlnclows, A Iling glass cloors
ands, all hurricane impact.
CONSTRUCTION INFORMATION:
�I4a workto ewer orme under this perryit 6c ec a apply: •
H--HVAC ILJI Gas Tank #]Gas-Piping _Shutters a Windows/Doors
ET i ❑ P • on
ins Si ers El enG eraf6r , ❑ , �oof itc
Total Sq. Ft of Construction: S . Ft. of First Floor:
=ostan i 55,380 � I��S we e� � g � '.04 A- -—
OWNER/LESSEE: CONTRACTOR:
Name Marie J Rozek* _ Name: Janet Milici
Address:8880 S Ocean Dr#1405 Company: Natural Flow, In -
City: Jensen Beac tate:FLO Address: 391 NE Baker Rd.
Zip Code: 34957_Fax: City: Stua State:Fly
Phone No.772-229-850 Zip Code: 34994— Fax: 772-334-1078
E-Mail:mimijohnflorida@aol.com Phone No. 772-334-1011
Fill in fee simple Title Holder on next page l; 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. ,
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DESIGNER/ENGINEER: _Not Applicable 0 MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: St City: State:
Zip: Phoneme 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 certify that no work or stallation s cor enced pr4ito j6ssuance o pe i
St. Lucie County makes no representation that is granting a permit will authorize fe permit ho er to ui t e su sect 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, pe for the
in accordance with the approved plans,�e4orida Building Codes and St. Lucie County Amendments
The following building permit applications are exempt from undergoing a full concurrency review: room a itionSA
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 0
improvements to your property. A Notice of Commencement must be recorded in the public records of S
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consul
with lender or an attorney before commencing work or recording our Notice of Commencement.
• • ,
Sigma ture of O Lessee/Con act�a5 ge r r • ture of C n rac r/Licens Holde • • -
STATE OF FLORIDA II STATE OF FLORIDA 0
COUNTY OF h ALD 0 4OUrY�F M 11j
Sworn to(or affirmed)and subscribed before me o Sworn to(or affirmed)and subscribed before me of
Phusical Presence o Online Notarization �hysical Presence or_Online Notarizatiga
this day of QV 1/ t� = )y this—day of 1(AIi��YVI('J�� , MR by •
Z6Z ZOZ 1
Name of person ma#g statement. Name of oerson making statement.
Personally Known�ll• OR Produced Identification_ Personally Known 7, IWOR Produced Identification—
Type of IdentificatioAN" Type of Identification 11MIll • • —
Produced Produced
Si nature of of ry P blic-State of Florida ) (Si nature of N ar PL lic-State of Florida )
Commission No. 5 "� (shy Public State of Flor Co mission No. / 6:9 _( al
na Jayne Hall • ysr►ty� ota Public State l Flon
My Commission GG g `�Donna Jayne Hall
8
Expi es 04l151202
REVIEWS$ FRONT Z I • SUPERVISOR PLANOS VIGETATIOWN
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE • • • • • • • • —
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DATEPLETED •
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