HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 04/28/2020 Permit Number: ��� a y
COLINITY
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
PERMITTYPE: MOBILE HOME DEMOLITION
PROPOSED IMPROVEMENT LOCATION:
Address: 2151 NETTLES BOULEVARD, JENSEN BEACH, FL, 34957
Property Tax ID#: 4502-501-0154-000-5 Lot No. 151
Site Plan Name: Block No.
Project Name: THOMPSON HOME PROJECT
DETAILED DESCRIPTION .Of WORK.
DEMOLITION OF MOBILE HOME TO MAKE WAY FOR NEW CONSTRUCTION OF A SINGLE FAMILY HOME
CONSTRUCTION INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors
Electric _Plumbing _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: 1�2 Sq. Ft.of First Floor:
Cost of Construction:$ Utilities: Sewer _Septic Building Height:
.OWNER/LESSEE:.; 's CONTRACTOR: .
Name STEVEN THOMPSON Name: MACK MATOS
Address: 24 FANNING AVENUE Company: MEL-RY CONSTRUCTION
City: EAST HAMPTON State:_ Address: 10967 S. OCEAN DRIVE
Zip Code: 11937 Fax: City: JENSEN BEACH State:FL
Phone No. Zip Code: 34957 Fax:
E-Mail: Phone N0772-229-9440
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 LicenseCGC059412
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
If value of HVAC is$7,500 or more,a RECORDED Notice-of Commencement is required.
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SUPPLEMENTAL CONS(RUCTION LIEN LAW INF,ORIVIATION
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: 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 JOB SITE BEFORE THE FIRST INSPECTION. IF YOU INTEND TO OBTAIN FINANCING, CONSULT
WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT."
Signature of Owner/Lesse Contractor as Agent for Owner Signature of Contra r/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF ST.LUCIE COUNTY OF ST.LUCIE
The forgoing instrument was acknowledged before me Thef r oing instrument was acknowledged before me
this�day of uti 1 2iP� by this T4 day of kv IN 20 20 by
Name of person making statement. Name of person making statement.
Personally Known P6/ OR Produced Identification - Personally Known V OR Produced Identification
Type of Identificatio =Notar.y
Type of Identificati
Produced State of FloridaProduced K
ry Public State of Florida?
/ afer R Schafer/ on GG 308842 ommission GG 308842�, /2023 ` es 03/06/2023
A 04 ON
( ' re of otary Public-State of Florida) (Signature of otary Public-State of Florida)
Commission No. (Seal) Commission No. (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
Rev.