HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
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 Residential x
PERMIT APPLICATION FOR: Demolition ';
PROF.OSED°1`,IVIReROVENIENT.LOCATf N': ' M
Address: 2005 Nettles Boulevard Jensen Beach,FL 34957
Legal Description: Nettles Island Inc,A Condo-Section I Parcel 5 and Pro-Rata Share in Common Elements(OR 3917-1558)
Property Tax ID#: 4502-501-0008-000-7 Lot No.2005
Site Plan Name: Block No.
Project Name:
Setbacks Front 10 Back: 5 Right Side: -6 Left Side: 8
- "U
DETAILED-DESCRIPTION OF`1N0' RK: °"":
Removing trailer
CONSTRUCTION INFORMATION
Additional wor toa ertormed under this permit—check all appy:
HVAC Gas Tank []Gas Piping _Shutters Windows/Doors
11 Electric F1 Plumbing Sprinklers ElGenerator E] Roof Roof pitch
Total Sq. Ft of Construction: S Ft.of First Floor:
Cost of Construction:$ /` �o Utilities:Sewer F_1 Septic Building Height:
,bWNER/LESSEE: CONTRACTOR:'
Name Ronald R Kexel&Mary D Kexel Name: Mack Mack
Address:2005 Nettles Blvd. Company: Mel-Ry Construction
City: Jensen Beach State:FL Address: 10967 S Ocean Drive
Zip Code: 34957 Fax: City: Jensen Beach State:FL
Phone No.561-254-8416 Zip Code: 34957 Fax: 772-229-9440
E-Mail: Phone No. 772-229-9439
Fill in fee simple Title Holder on next page( if different E-Mail: Mack@mel-ry.com
from the Owner listed above) State or County License: State:059412 County:23630
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN.°LAW 1NFQRMATI0N= .
DESIGNER/ENGINEER: Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
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 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.
R v s
SigMp7WrrLefofm0:wneraLessee/ ontrac r as Agent for Owner Signature of Contr ctor/License Holder
STATE OF FLORIDA /r STATE OF FLO�`DA
COUNTY OF S /�✓�' �� COUNTY OF LUr-0",
The for oing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 9 day of IaCed, 20 /-7by this_a.,,day of V"%4-f 20 by
(Name of person acknowledging) (Name of person acknowledging)
L&A—
(SignaltrKe of Notary Public-State of Florida ) (Signature of Notary Public-State of Florida)
rsorially Know ro ugg tJtW $�n Personally Known OR Produced Identificationfi
Type o entifica q}�q d to of Florida Type of Identification Produced L
_ . Commiaslon N GG 007074
Commission No. g� My Comm.,I(JOE#Oct 12,2020 Commission No. C. DEANNAtgIl'GI NS
,,����n��, _ • = Y COMMIS I c 072023
��,���•� Bonded through National Notuy Assn. �*= EXPIRES:December 16,2020
ters
Dull
Revised 07/15/2014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
Fianning$;DevelopmeaESen{ices ASBESTOS NOTICE
Building A Goo6 Regulation Division.°
2300 Virginia Avenue;
Fort Pierce,FL 34982
Phone:(772)462-2172 Fax:(772)4624443
Asbestos Notice to Contractor
March 02, 2017
MEL-RY CONSTRUCTION , F
1n 9ACK 67 S OCEAN EAN DR ILS �F.
JENSEN BEACH, FL 34957
RE: Building Permit Number 1703-0063
It is your responsibility to comply with the provisions of Section 469.003, Florida Statutes and to notify the Department
of Environmental Protection of any intentions to remove asbestos when applicable in accordance with state and federal
law.
Signature
i
Date
3/2/2017 2:11:47 PM