HomeMy WebLinkAboutStorch Permit applicatrionALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Cc>uNTY `
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: To Select from dropbox, click arrow at the end of line QWin r'ti
PROPOSED IMPROVEMENT LOCATION:
Address: 1397 NETTLES BLVD
Legal Description: NETTLES ISLAND INC, A CONDO -SECTION 11 PARCEL 1397 AND PRO -RATA SHARE IN COMMON ELEMENTS (OR 1544-687)
Property Tax ID #: 4502-501-1584-000-5
Site Plan Name: Storch
Project Name: Storch
Setbacks Front Back:
Service change - like for like
Right Side: Left Side:
Lot No. 1397
Block No.
rAu�ond1 worK to A�hat rrormea unaer tnis permit — cneck all tapply:
HVAC Gas Tank E]Gas Piping lu_' Shutters ❑ Windows/Doors
aElectric F]Plumbing Sprinklers El Generator F]Roof Roof pitch
Total Sq. Ft of Construction: 643 Sq. Ft. of First Floor:
Cost of Construction: $ 1500 Utilities:Sewer LJSeptic Building Height:
O NERAESSEE:
CONTRACTOR:
Name Valerie Starch
Address: 1273 North AVE Apt 8-3H
Name: Donald B Green
Company: Don Green Electric LLC
City: New Rochelle State: NY
Zip Code: 10804 Fax:
Phone No.
E -Mail:
Address: 1305 W 1 st Street
City: Fort Pierce State: FL
Zip Code: 34982 Fax:
Phone No. 772-418-5739
E -Mail: dongreenelectric@gmail.com
State or County License: EC13007447
Fill in fee simple Title Holder on next page (if different
from the Owner listed above)
1 vcnuv ul sunstrucnon is ?couu or more, a KtLVKutu notice of commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION;
DESIGNER/ENGINEER: X Not Applicable
Name:
MORTGAGE COMPANY: Not Applicable
Name:
Address:
City: State:
Zip: Phone:
Address:
City: State:
Zip: Phone
FEE SIMPLE TITLEHOLDER: Not Applicable
Name:
BONDING COMPANY: ,Not Applicable
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
comm"cin work or recording your Notice of Commencement.,,
—4 1 4A
/D J
A -
Signature of Owner/ Lessee/Contractor as Agent for Owner
Signat re of Contractor/License Hol r
STATE OF FLORIDA
STATE OF FLORIDA
COUNTY OF MARTIN
COUNTY OF MARTIN
The forgoing instrument was acknowledged before me
The forgoing instrument was
acknowledged �b,,efore me
this s day of December 20 by
this s day Of December
, 20 I uby
DONALD B GREEN
DONALD B GREEN
Name of person making statement
Name of person making statement
Personally Known X OR Produced Identification
Personally Known X OR Produced Identification
Type of Identification
Type of Identification
Pr c
1�
Prod ed
(Sign ture of Notary Public- State of FI rida
Sint e hrid - Stu
Y�CyR�STINECnsa�.
Commission No.
�: P CH TINEC(�PE ^rl�
JOY CHRISTINE
Otr"YP�eG£ I�S1nEC�¢��.
2 �E ��
r,tF_
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEATURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev. 8/2/17