HomeMy WebLinkAboutBUILDING PERMIT APPLICATION4' t
ALL APPLICABLE INFOMUSTBE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: -,5 ` ` SCANNED Permit Number.
BY =RECEIVEDSt. Lucie County
Building Permit ApplicationPlanning and DevelopmentServicesBuilding 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— C, o"o
PROPOSED IMPROVEMENT LOCATION:
Address: 9940 S OCEAN DR #501, Jensen Beach, FL
Legal Description: OCEANA OCEANFRONT CONDOMINIUM ONE APT 601 AND .8625 PERCENT INT IN COMMON ELEMENTS (OR 3286-898)
Property Tax ID #: 4502-502-0048-000-2
Site Plan Name:
Project Name:
Setbacks Front Back:
Right Side: Left Side:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK: III
Replace sliding glass door with hurricane impact sliding glass door
CONSTRUCTION INFORMATION: III
und1 wvFR w ue enunneu unue[ una
HVAC Gas Tank ❑Gas
Electric 'Plumbing
Penns—a1ecR do dppry:
Piping _ Shutters
Sprinklers Generator
✓Q
Windows/Doors
Roof = Roof pitch
11
Total Sq. Ft of Construction: Sq. Ft, of First Floor:
Cost of Construction: $ 7,975 Utilities: I0Sewer ElSeptic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name William J Tivoli
Name: Janet Milici
Address: 9940 S Ocean Or Apt 501
Company: Natural Flow, Inc.
City: Jensen Beach State: FL
Zip Code: 34957 Fax:
Phone No. 772-229-1591 (914) 582-2171
Address: 391 NE Baker Rd.
City: Stuart State: FL
Zip Code: 34994 Fax: 772-334-1078
Phone No. 772-334-1011
E-Mail: ctivoli@yahoo.com
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
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.
EER: _
Name:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not Applicable
Name:
Address:
City:
Zip: Phone:
MORTGAGE COMPANY: _ Not Applicable
Name:
Address:
City: State:
Zip: Phone:
BONDING COMPANY:
Name:_
Address:
Zip
Not Applicable
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 YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING,. CONSULT
wrTH YOLIR r FNnFR nR AN ATTnRNFY RFFnRF RFCr1RnING YOUR NOTICE OF COMMENCEMENT."
Sig=atureofntractor/License Holder
SignaCofOr/ Lessee/Contractor as Agent for Owner
STADA
STORIDA
COUNTYOF ST. LUCIE
COUNTY OF ST. LUCIE
The forgoing instrument was acknowledged before me
MALI 20VI by
The fmoing instrument was acknowledged before me
this day Y✓ 'f 20LI_ by
this-3ru day of
of
Janet Milld
JanetMillet
Name of person making statement.
Name of person making statement.
Personally Known X OR Produced Identification
Personally Known X OR Produced Identification
Type of Identification
Type of Identification
Pro�duc�ed��
Produced
(Signature of N y Public St�Ce f�l,{ry�RP�1Peolic state o on a
Jayne Hall
(Signature of Nota P bliWStatelori'Donn
My commissionGG207585
Commission No.2075ss p RoE(pj�941752022
Nota�ry��vp�gI state of Florida
Commission No.207585it.Don la �eHall
F.My commission GG 207585
Expires 04/1512022
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