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ALL APPLICABLI INFO UST BE COMPLETED FO APPL116'_ _A Tom CEPTED I
Date: J1AN I ' 2016 Permit Number:
Building Permit Application
Planning and Development Services,
,Building and Code Regulation Division
2300 Virginia.Avenue,Fort Pierce FL 34982
1Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR': Addition
RR0POSfDfIMPROVEMENT LbCAI"I'ON.:. ,
Address: 1271 Nettles Blvd.,Jensen Beach, FL 34957
Legal Description: Lot 1271, Section II, Outdoor Resorts of America at Nettles Island
Pi opertyTax ID#: 4502-501-1458-000/3 Lot No. 1271
Site Plan Name: Block No.
Pi oject Name:
Setbacks Front 10 S Back: 5 Right Side: 0 •z. Left Side: 8 .L%
I
DETAILED'DESCRIPTION ,O:F-.WORK:,
Extend rear deck to setback and replace front deck and stairs
CORISTRUCTION INFORMATION':
dclitional work to (e ne orme, under t is permit—checka apply:
E1HVAC �I Gas Tank Gas Piping Shutters a Windows/Doors
Electric. ❑ Plumbing Sprinklers OGenerator Roof
Total Sq. Ft of,Construction: S Ft. of First Floor:
Cost of Construction:$ 3300.00 Utilities: Sewer Septic Building Height:
bWNER/LESSEE CONTRACTOR:
Name William C.and Patricia Raper Name: James W. Newman
Address:301 S. College St_, Ste. 3500 _ Company: JWN Builders, LLC
City: Charlotte State. Address: 1701 SE Carvalho St.
Zip Code: 28202 Fax: City: Port St. Lucie State:FL
Phone No. - Zip Code: 34983 Fax: 772-871-9500
E-Mail: Phone No. 772-871-9500
Fill in fee simple Title Holder on next page(if different E-Mail: jwnconstruction@comcast.net
from the Owner listed above) State or County License: CRC1328282
If'value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
I
SUPPLEMENTAL.CONSTRUCTION LIEN,LAW INFORMATION:-
DESIGNER/ENGINEER: ^Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Quantum Engineering Associates,Inc. Name:
Address:300 Avenue of Champions Address:
City: Palm Beach Beach State: FL City: State:
Zip: 33418 Phone: 561-202-6994 Zip: Phone:
FEE SIMPLE TITLEHOLDER: _Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
II 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 work or recording our Notice of Commencement
i
SI gnature of Owner/Agent/Lessee Sign ure of Contractor/License Holder
STATE OFO_ SATE OF FL IDA
COUNTY OF COUNTY OF
I he forgoing instrument was acknowled re me The f oing instrument was acknowledged before me
this day of 2 _ this day of. (�4� ,20
by _Rby
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( ame of person acknowledging) (Name of person acknowledging)
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u lte o �t ��iM (Signat a of Notary Public-State of FloridaPersonally OR Prod ced IdentV;c "A1 Personally Known ,
Type of Identification Produced \ / Type of Identification MA MILLS
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REVIEWS FRONT ZONINO'io �UyPEI�V �e1'LANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW /// FIR REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE 1)'�' �1
INITIALS