HomeMy WebLinkAboutBuilding Permit ApplicationALL 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
Address:
Legal Description: NETTLES ISLAND INC, A CONDO -SECTION II PARCEL 1068 AND PRO -RATA SHARE IN
COMMON ELEMENTS (OR 4135-2079)
Property Tax ID #: 4502-501-1255-000-0
Site Plan Name: 1068 Nettles Blvd
Project Name: 1068 Nettles Blvd
Setbacks Front Back:
DETAILED DESCRIPTION OF WORK:
Install electric for dock (permit 1807-0380)
Right Side: Left Side:
Lot No.
Block No.
CONSTRUCTION INFORMATION:
Additional work toa er orme under this permit –check a appy:
HVAC 11 Gas Tank ❑Gas Piping Shutters a Windows/Doors
R] Electric E] Plumbing Sprinklers E]Generator Roof Roof pitch
Total Sq. Ft of Construction: 2038
Cost of Construction: $ 1900
S.Ftj. of First Floor: _
Utilities: L _ISewer — Septic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name Sunset Dream Homes LLC
Name: Donald B Green
Address: 17440 NW 82nd CT
Company: Don Green Electric LLC
City: Hialeah State:FL
Zip Code: 33015 Fax:
Phone No.
Address: 1305 W 1st Street
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No. 772-418-5739
E -Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E -Mail: dongreenelectric@gmail.com
State or County License: EC13007447
If vdwe or constru"ion is -P[suu or more, a 11MUKUtU Notice of Lommencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X— 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, l 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
t,uinnienan wurK Ur ieLutuirig your Notice oT t-ommencemeni.
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF Martin COUNTY OF Martin
The forgoing instrument was acknowledge efore me The forgoing instrument was acknowledged before me
this 27 day of September 2pby this 27 day of September 20 by
Donald B Green
Name of person making statement
Personally Known X OR Produced Identification
T*"
ypVurf
cation
Pro
(Sigotary Public- Stale
Commission No.
My ,IIjSSON#FF94 ®42
EXPIRES: JAN 05, 2020
NLmawBonded through 1st State Insurance
Name of person making statement
Personally Known X OR Produced Identification
Type of Identification
Produc
(Signatu o N ry Public- St a ----
=ot v o J Y CHRIS77NE COPELAND
Commission No. �"SION #FF948042
41 IBES. JAN 05, 2020
Bonded through 1st State Insurance I
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17