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ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED J� �]Date: 12/28/2018 Permit Number: fQC'/ Ol/- + _
S , r: RECEIVED
COUNTY' -1';',:: ,
F.'..I. O 1. t D A „ . APR 0 2018
wimsumilmosi Building Permit Application
permitting Department
Planning and Development Services St.Lucie County
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 El
PROPOSED IMPPROVEMENTLOCATION
Address: 1343 Nettles Blvd.Jensen Beach, FL 34957
Legal Description: NETTLES ISLAND INC,A CONDO-SECTION II PARCEL 1343 AND PRO-RATA SHARE IN COMMON ELEMENTS(OR 3501-2689)
Property Tax ID#:4502-501-1530-000-2 Lot No.1343
Site Plan Name: Block No.
Project Name:
Setbacks Front_ Back: Right Side: Left Side:
DETAILED; DESCRIPTIONOF WORK ,- -
Removing oId trailer e
r -
CONSTRUCTION:I N FORMATION
Additional work to be erformed under this permit-check all lila apply:
OHVAC Gas Tank EGas Piping I_Shutters E.Windows/Doors
0 Electric 0 Plumbing E]Sprinklers 0 Generator Roof I Roof pitch
Total Sq. Ft of Construction: S.. Ft. if First Floor: _
Cost of Construction:$ r 1� Utilities: •Sewer 0 Septic Building Height:_
OWNER/LESSEE A ;' CONTRACTOR:
Name Walter&Gretchen Saul Name: Mack Matos
Address:925 Little Lehigh Drive i Company: Mel-Ry Construction
City: Emmaus _State:PA Address: 10967 S Ocean Drive
Zip Code: 18049 Fax: City: Jensen Beach State:FL
Phone No. "772' 2 9 t) 3 Zip Code: 34957 _ Fax: 772-229-9440
E-Mail: Phone No. 772-229-9439
Fill in fee simple Title Holder on next page(if different E-Mail: Mack@mel-ry.com
from the Owner listed above) State or County License: GC059412
I
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN.LAW INFORMATION
DESIGNER/ENGINEER: _Not Applicable MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: _State:
Zip: Phone . ' Zip: Phone:
FEE SIMPLE TITLE HOLDER: _Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address:10967$Ocean Drive 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 wort,or recording your Notice of Commencement.
. c____„.....--2,7,zry(1.---37 :2-
Signature of Owner/ Lessee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIB ] STATE OF FLORIDA,,,,," c.
COUNTY OF --7-T,/mate— 7'r C(e_ COUNTY OF � L (JUL _
The forgoing instrument was acknowledged before me The forgoing instrume �1 nt was acknowledged efore me
L(
this day of Hp't L ,20 I by this 9 day of ,20. by
La,N,,,_ ,,,,L
- _ ••.rson making statement Name of persoaking statement
Personally Known OR Produced Identification Personally Known OR Produced Identification
,•- o •en i 'cation Type of Identification
Produced Produced
tl „I - _ _ f_ _ _ _ _ _ _ _
.l,' _� ) CHRISTINE Mans /1-.
•
(Sign of Not- " ��gqr at fiii# a•Istate of Florida (Signature of No ary • b S o F 1
commission il!GG 07074, ,p' R blip stere or Florida
Irt Brian R Schafer
Commission No. 'e, -.= Comin,t OCOZ260 L Commission No. MYCo4lanGG308842
"e%? Bondedtlnoup%N$ll i N9tat Atte. a w Expires 03/08 023
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.8/2/17