HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONDate: V V ' Permit Number: _
NEW.
69
PuildllfflyO�ermi?A:li�tion
Planning and Development Services
Building and Code Regulation Divisio
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-15780 Co2rrlercial X *Residential
PERMIT APkICATION FOR;&Window/doo 1�
AddresIM9500 S OCEAN DR 1603, JENSEN BEACH, FL 34957
Lega"scription: ISLANDIA II CONDOMINIUM UNIT 1603 (OR 2593-474: 2618-1315)
Property Tax ID #: 4502-602-0147-000-3 Lot N
Set acr nt� 0 Back: Right Side: Left Side:
INFORMATION:
Additional work to e "'to rmeunder this permit — c ec
*HVAC Gas Tank [*Gas Piping
c nc ❑ i
g
•
!i:4
Total Sq. Ft of Construction:
Cost ofcons ruc ion: 1,850
OWNER/LESSEE:
Name Albert A Reker
Address: 11357 SW 86th Ln
City: Miami
_ State: FL
_J
Zip Code: 33173 4000wax:
Phone No. 305-431-0689
E-Mail: Barek1012@gmail.co
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
=H Ri ...
LJ Shutters
S . Ft. of First Floor:
S'!! 0!
CONTRACTOR:
Block No.
windows/•ors
It i1ol-
Name: Janet Milic
Company: Natural Flow, Inc.
Address. 391 NE Baker Rd.
City: Stuart _ tate: FLU
Zip Code: 34994 — Fax: 772-334-107840M
Phone No. 772-334-1011
E-Mail: Janet@naturalflow.net
State or County License: SCC 131151263
If value of construction is $2500 or more, a RECORDED Notice of Commencement is required.
DESIGNS
Name:m
Address:
City:
Zip:
Not AoolicableAh
State:
Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable•
Name:_
Address:
City:
Zip:
Phone:
MORTG�E C?"tJ:!lNot Applicable •
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY: Not Applicable
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 certify that no work or installation has commenced prior to the issuance of a p rmit. •
StOie An%JOU citation A ifantiroppermit will othorizh�ermit 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 appl _
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the worA
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, feces, i signs, scrr&roo oryyanoMyoln
- e�ia use
W RNING TO OWNER: Your failure to Re ord a Notice of Commencement mly result itNice for
improvements to your property. A Notice of Commencement must be recorded in the public records
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.
Signatur of Own / Lessee/Contractor as Agent for Owner Signatu e of Co ractor/License Holder
STATE O O • • • • ' STATE OF FL D •q•
COUNTY OF 4" MA-�TI 0 COUNTY OF-- I �J ` ►�'
Sworn to or affirmed) and subscribed be ore me o wo 0 or affirmed) and subscribed be ore me o
AhOcal Presence or Online NotarizationWP�hysical Presence or Online Notarization
da of 17F�'C-r<►t by • ZP day ofycn( r E2 -k 2M bo
�J � I,bl`1U v
Name of person making statement Name of person making statement.
7ersonlaay nowno uccee e i a n Personally Known X OR Produt Identification•f Identification Type of Identification
Produced --]%A,
Produced
nature of N
Commission No.20 1 J'9
REVIEWS • FRONT
COUNTER
of Florida )
oNSe"ary Public State of FL
Donna Jayne Hall
My Commission GG 207
REVIE
DATE
RECEIVED • • •
DATE
COMPLETED —
ev
ature of No
Isslon
tak�l IC $t �y da 4otaryPuW�c State of
Zu7 5�i 5 !FyDonna Jayne Hall
��pmm'ssion GG 2
Ah �A-__I Expires 04115I202aM
. SUPERVISOR PLANS I VEGETATION SEATURTLE MANGROVE
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