HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE� INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED �(fJ �--
Date: % -2-11 Permit Number: / °' - qr V ' `�--
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w� __ _. :. _--..w --.�,__M Building Permit Application e��°,� r�o 110 �®
Planning and Development Services �aysp� O0 ,
Building and Code Regulation Division .,
2300 Virginia Avenue,Fort Pierce FL 34982E
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential
PERMIT APPLICATION FOR: De#,,i o/,-f/-oh
PROPOSED INPROVEMENT LOCATION ..
Address: 5-4/ Pe79/eS Ski terse, Beach , / .. 3%957
Legal Description: / '#/f1 l /4ho1 Inc. (Li/42 "2/77)
Property Tax ID#: y5-O2` 5-0/' 0VVO - 000- 7 Lot No. 25-9
Site Plan Name: 4/1/e itie-J Block No.
Project Name: .29/
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION;OF WORK:=
Comic to e?4,7,o/,-/-,-oh 946/ re.29®le-a/ o o'8., sir. 06,'/e ,o/ve
on c/ 'ot. % roam
CONSTRUCTION INFORMATION
Additional work to be performed under this permit-check all that apply:
_Mechanical _Gas Tank _Gas Piping —Shutters Windows/Doors
—Electric .. _Plumbbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: O gg Sq. Ft. of First Floor: .6(8'�
Cost of Construction: $ 09Q0.o0 Utilities: Sewer _Septic Building Height: 3 )(
OWNER/LESSEE,
CONTRACTOR:'
;. . :
Name 844 ° 4 Tfvaitrne4 5 LLC Name: - /04ey). 5...--,0/74/7
Address: /539;,;f W ...0/Gy ,4e. Company://%,4 ...5-/o/IX. .9 _f
City: 5r in. r9i®i / _ State:1772- Address: 6'/ , `f e4cer. Si.:
Zip Code:4/9597-.7712 Fax: City: 4Te•'se, /e 4A State:/L.
Phone No. �f/6' 262- 239 Zip Code: .7//9�_7 Fax: 77?-232-.2)9/
E-Mail: Phone No 772-24'0 -37/3-
Fill in fee simple Title Holder on next page(if different E-Mail 4dez m Si %f'h i e7C ®)/#I . coin
from the Owner listed above) State or County License C.IC 1.257 9f/
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
1
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: \ Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:.. -
Address: Address:
City: State: City: State:
Zip: Phone Z •. Phone:
FEE SIMPLE TITLE HOLDER: Not Appli . e BONDING CO ' A NY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: ne: 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
commencin: wor 9r recordin:. G r Notice of Commencement.
'"A.'
Signature of Owner/Lessee/Contractor as Agent for Owner Signatu e of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORI ,®v
COUNTY OF ®IV\ ; A✓ COUNTY OF 1\(j/
The forgoing instrument was cknowledged before me The forgoing instru ent�wa acknowledged efore me
this (`3 ? 0'"ay of - r, i ,20 ) by this I day of C1 1 , 20 /6 by
.
*(1;;C* 5 M` A '0,44 5A4 , z
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(Nam; of person acknow.-dging) (Name o ; ,erson acknowled•:ng)
11 r
.aima a_
__ ____.
(Signat - of Notary •. •lic-State of Florida ) (Signature of Notary Public-State of Florida) p -
Personally Known OR Produced Identification Personally Known OR Produced Identification _
Type of Identificatio Type of Identificatio
Produced -L. NI_
Produced
Commission i\o.i:i.. ,, DURA li Commission No. : ►e.•:':' .- . DURARA Fsaa'gYS
`,' 'i MY COMMISSION-0 FF237917 =, •• MY'COMMISSION-A FF2379T1
a` = EXriRES June 04.2019 - ,
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REVIEWS ' ~='�°. -• : ne 04 2019
� "' ' �' 2"`"t- ERVISOR PLANS VEGE ;'a ;, .o:c,• A �' ';""'IP ES"ryfpGott
MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
ley. 7/2014
EXifiBIT B
UNIT OWNER AUTHORIZATION FOR CONTRACTOR
ACCESS TO UNIT PROPERTY
Unit Owners must complete the following authorization form to permit ongoing contractor access to unit
property for construction work or activity. Form must be received by NI Condo Office or Security Office prior
to commencement of construction work or activity.
1. Lot Number: 59
2. Owner Name:
3. Name of Contractor/Business: /Ur77 _5;7/711 5erv-i-e.
4. Point of Contact for Contractor/Business: /47aPPI J./Cl/
5. Point of Contact Phone Number: 772 — — 7715--
6. Start Date: /74-7— /7 End Date: 4"-30 —1F
7. Contractor Authorized to Call Others (Sub-contractors) In": Yes / No
OWNER SIGNATURE:
**If"Yes" is selected,this allows your contractor to contact the Security Department directly to let them know
that a sub-contractor/party/person(s)will need access to perform services on your unit. Security will not need to
contact you directly to allow entry for other sub-contractors/party/person(s)working under your contractor. If
"No" is selected, Security will need to verify with you, the owner, that access to your unit is approved.
Nettles Island Security or Condo Staff will enter the contractor into our Community Management System,
allowing entry to the contractor for the date range specified. The Community Management System will also
note whether or not you approved your contractor to authorize sub-contractors/party/person(s)to your unit.
If you have any questions regarding this,you can reach the Condo Office at 772-229-2930 Monday through Friday 08:30
AM to 12:00 PMand 12:30 PM to 4:00 PM.
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