HomeMy WebLinkAboutBuilding Permit Application S'
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED -1
Date:��1 �'1 Permit Number: 1 1-•d �,s
RECEIVED
Building Permit Applicatic n
Planning and Development Services NOV 0 3 2017
Building and Code Regulation Division
2300 Virginia Avenue,Fort Pierce FL 34982 p��' (�j p Department
Phone: (772)462-1553 Fax: (772)462-1578 Commercial. e �� e v. FL
PERMIT APPLICATION FOR: Mechanical
P=RO,,POSED,IIVIRROVEMENT LOCATIOIN
Address: 510 NETTLES BLVD,JENSEN BEACH, FL 34957
Legal Description: NETTLES ISLAND INC.A CONDO-SECTION II PARCEL 510 AND PRO-RATA SHARE IN COMMON ELEMENTS
(OR678-1423: 681-1147: 1147-1453: 3647-1076)
Property Tax lD#: 4502-501-0696-000-6 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front ;s w. . Back: Right Side: Left Side:
"ETAfILE'® ®'f SCRII!PTUUN ®�F W®�-f P-
" . .
3 TON
14 SEER
10 KW
CO;N�S`�TR'UYCTIO IINiFO,RalUl=ATI(O1N
Additionalwork toe nerformed under this permit-check all appy:
_ VAC Gas Tank E]Gas Piping _Shutters Windows/Doors
1-1 Electric ❑ Plumbing Sprinklers Generator Roof Roof pitch
Total Sq. Ft of Construction: 869 SFt. of First Floor:
Cost of Construction:$ 4900.00 Utilities:n Sewer Septic Building Height:
O° NE-R/LESSEE: CQa TRACT 3�R� n .�
ten_ . . _ .�
Name:JAMES MOLLOY Name: MARK A VINES
Address:510 NETTLES BLVD Company: AZTIL
City: JENSEN BEACH State:_ Address: 2540 S MILITARY TRAIL
Zip Code: 34957 Fax: City: WEST PALM BEACH State:FL
Phone No.772-229-5589 Zip Code: 33415 Fax:
E-Mail: Phone No. 561-433-2197
Fill in fee simple Title Holder on next page(if different E-Mail: PERMITS@AZTILAC.COM
from the Owner listed above) State or County License: CAC049253
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
S U=P FiUBMI,E?N if/AIUC0 N'STR U:CTI'0 N LI E N LAW IIN1F0'RM'A�Ti 10,NI:
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
N a me::JAMES MOLLOY Name:MARK A VINES
Address:510 NETTLES BLVD,JENSEN BEACH,FL 34957 Address: 510 NETTLES BLVD
City: JENSEN BEACH State: City: WEST PALM BEACH State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address:2540 S MILITARY TRAIL 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
comme ork or recording our Notice of Commencement.
Sig ature of Owner/Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF PALM BEACH COUNTY OF PALM BEACH
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this 2 day of NOVEMBER 20_ by this 2 day of NOVEMBER 20_ by
Name of person making statement Name of person making statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Type of Identification
Produced Produced
Signature • N a Y CONfMtSS�ON#FF077427 % at of N r sfii ,' &MHblrIE11D7V RD GIFFORD
o= s MY COMM SION#FF077427
FOFFoa.° EXPIRES S@g ber 17,2017
Com issi- No. ommis ' n " Q, ember 17,2017
98-0153 Floridallota Service.com
(407)390-0153 FloridallotaryService.com
REVIEWS FRONT ZONING UPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW, REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17