HomeMy WebLinkAboutBuilding Permit ApplicationAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED ,Date: Permit Number: aco? '-(00C) T
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Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial Residential
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Concrete Restoration :R_.P,
Address: So. Ocean Drive, Jensen Beach, FL 34957
Property Tax ID #: 4501-501-0000-000/0 Lot No.
Site Plan Name: Outdoor Resorts @ Nettles Island, Plat Book 16, Pagesl, 1A-1J, St. Lucie County Block No.
Project Name: NETTLES ISLAND, INC., A Condominium
Concrete Restoration on pool equipment building
New Electrical Meter Second Electrical Meter
Additional work to be performed under this permit— check all that apply:
_Mechanical ^ Gas Tank —Gas Piping _ Shutters
_ Electric _ Plumbing _ Sprinklers
Total Sq. Ft of Construction: r
Cost of Construction: $ d 0W
_ Generator
Sq. Ft. of First Floor:
Windows/Doors _ Pond
Roof Pitch
Utilities: -Sewer _Septic - Building Height:
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Name Nettles Island, Inc.
Name•Luis F. Libreros
Address:9801 So. Ocean Drive
Company: Conquer Restoration by Golden Construction
City: Jensen Beach State: _
Address:5877 Las Colinas Circle
City: Lake Worth State: FL
Zip Code: 34957 Fax:772-229-9901
Phone No.772-229-2930
Zip Code: 33463 Fax:
Phone No561-827-7148
E-Mail:manager@nettlesislandcondo.com
Fill in fee simple Title Holder on next page ( if different
E-Mail goldenconstructionl5@yahoo.com
from the Owner listed above)
State or County License Florida
it value of construction is Z500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,S00 or more, a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER: _ Not Applicable
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MORTGAGE COMPANY:
x Not Applicable
Name:
Name:
Address:
Address:
City: State:
City:
State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY:
x 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 ail 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 paying twice for
improvements to your property. A Notice of. Commencement must be recorded in the public records of St.
Lucie County and posted on the jobsite before the first inspection. If you intend to obtain financing, consult
with lender or an attornev before commencing work or recording vour Notice of Commencement.
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Signaturei�o wner/ Lessee/Contractor-as Agent for Owner
Signature of Contractor/License Holder
STATE OFTLORIDA
STATE OF FLORIDA
COUNTY OF st.Lueie
COUNTY OF
Sworn to (or affirmed) and subscribed before me of
Sworn to (or affirmed) and subscribed before me of
x Physical Presence or Online Notarization
Physical Presence or Online Notarization
this am day of July 2020 by
this day of 2020 by
a��P_r, A. sc
Name of persoA making statement.
Name of person making statement.
Personally Known x OR Produced Identification
Personally Known V OR Produced Identification
Type of Identification
Type of Identification
Produced
Produce
(Signature of Notary Public- State of Florida)
(Signa re of Notary Public- State�JR kj&ko
Commission No. otaryPt�0teofFlorida
Commission No. * COMMISSlon 34 13
ytf.- Kristen Gall Oliveira)
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