HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED J
Date: Permit Number:
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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
PROPOSED IMPhROVEMENT LOCATION:'',.'s
Address: 20 Nettles Boulevard Jensen Beach, FL 34957
Legal Description: Nettles island inc., a condo-section II parcel 20 and pro-rata share in common
elements (or 1510-2935;3502-654)
Property Tax ID#: 4502-501-0206-000-5 Lot No.20
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK
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CONSTRUCTION INFORMATION."
Additional work toa er orme under this permit—check a appy:
❑HVAC E] Gas Tank ❑Gas Piping _Shutters ❑Windows/Doors
❑Electric ❑ Plumbing ❑Sprinklers ❑Generator ❑ Roof Roof pitch
Total Sq. Ft of Construction:: SFt. of First Floor:'
Cost of Construction: $ I' Utilities:n Sewer❑Septic Building Height:
OWNER%LES' EE -CONTRACTOR',.': j.
Name Peter & Joan Casano Name: MaCK matos
Address: 1036 ear Drive Company:-Mel-Ry ons ruc ion
City: Lae Ariel State:VA_ Address: 10967 Kucean Drive
Zip Code: 18436 Fax: City: Jensen Beach State:
Phone No.570-445-1129 Zip Code: 34957 Fax: 29-944T
E-Mail:joanie yahoo.com Phone No.
Fill in fee simple Title Holder on next page (if different E-Mail: Mack me -ry.com
from the Owner listed above) State or County License: 23630
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION
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:
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 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.
Signature o Owner Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA`\ l _ / , n A-_ STATE COUNTOF 'Sl
OY FLORIDA UkC_k
COUNTY OF �'—�L—L-�'G�
The forgoing instr ent was acknowledged before me The f�o�ging instr en was acknowledge before me
this of 20L�y this 1 c� qday of ` 20� by
Name of person ing statement Name of person making statement
Personally Known OR Produced Identification Personally Known O� OR Produced Identification
Type of Identification Type of Identification
Produced Produced
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(Signature of Atary Public-State of Flor' Itignaye otary Pu lic-State lftVW-
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MY COMMISSION#F 2 168
LA M H FF —1 &T EXPIRES May O5. 0Commissiol E gtat Anda .. ��22 l' ir.;;asacasaHwayse.vrx.
���13Va Commission No. deal)
'O Q0.'"°Bi?, Notary Pu lic- g0
°�': Commission#FF 2347
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REVIEWS �i N1NG SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
` COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17
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Planning BDevelopment Services ASBESTOS NOTICE
Building&Code Regulation Division
2300 Virginia Avenue
Fort Pierce,FL. 34982
Phone:(772)462-2172 Fax:(772)462.6443
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Asbestos Notice to Contractor
September 20, 2017
MEL-RY CONSTRUCTION INC
MACK MATOS
10967 S OCEAN DR
JENSEN BEACH, FL 34957
RE: Building Permit Number 1709-0250
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.
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Signature
12o `
Date
9/20/2017 12:26:32 PM