HomeMy WebLinkAboutBuilding Permit Application All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: 5 aZS Permit Number:
ILUC � ,- RECEIVED_
0 -
a p p Building Permit Application Nw o 2020
Planning and Development Services Permitting Departmentst. Lucie County
Building and Code Regulation Division Commercial X Residential
2300 Virginia Avenue,Fort Pierce FL 34982
Phone: (772)462-1553 Fax: (772)462-1578
PERMIT APPLICATION FOR: Nettles Island, Inc., ,A Condominium pas
PROPOSED IMPROVEMENT LOCATION:.
Address: 9801 South Ocean Drive Jensen Beach, Florida 34957
Property Tax ID#: 4502-501-0000-000/0 Lot No.
Site Plan Name: Block No.
Project Name: Nettles Island Ocean Pool Pump Room
DETAILED DESCRIPTION,OF WORK
INSTALL NEW EXTERIOR PLASTPRO FIBERGLASS SWING DOOR FOR STORAGE ROOM
New Electrical Meter Second Electrical Meter
60NSTRUCTI IN INFORMATION:
Additional work to be performed under this permit—check all that apply:
_Mechanical _Gas Tank _Gas Piping _Shutters _Windows/Doors _Pond
Electric _Plumbing, _Sprinklers _Generator _Roof Pitch
Total Sq. Ft of Construction: Sq. Ft. of First Floor:
Cost of Construction: $ 1,000 Utilities: —Sewer —Septic Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name -.Name:..CHRISTOP.HER.McDONNELL
r
Address-9801 .:: �� - � Vv Company ,CONCOf Dp 1BUILDING'CORP
City: ., State: L dress:,_
City: , PLEASANT,. ,? ROVE WAY
Zip" e. Fail: .City PORT ST:LUCIE State:FL
Phone No. Zip Code: 34986 Fax: 772 621 7831
E-Mail: Phone No 7723365480
Fill in fee simple Title Holder on next page(if different E-Mail CONCORDBUILDINGCHRIS@GMAIL.COM
from the Owner listed above) State or County License CBCB50026
If value of construction is 2500 or more,a RECORDED Notice of Commencement is required.
If value of HAVC is$7,500 or more,a RECORDED Notice of Commencement is required.
S U,'PP,LEMENTALCONSTRU'CTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable MORTGAGE COMPANY: X Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: X 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 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 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 attorney before commencing work or recording our Notice of Commencement.
Signature of Owner/ essee/Contractor as Agent for Owner Signature of Contractor/License Holder
STATE OF FLORIDA STATE OF FLORIDA
COUNTY OF BaeVhao COUNTY OF akfVAQp
Sworn to(or affirmed)and subscribed before me of Sw rn to(or affirmed)and subscribed before me of
Physical Presence or Online Notarization Physical Presence or Online Notarization
this S day of Ncveft ra 2020 by this S day of /4'wergce 2020 by
c tS f�1cCi,;�tJs'u, t'li+L4< Nlcilrafe7e[1
Name of person making statement. Name of person making statement.
Personally Known Q1____ OR Produced Identification Personally Known J-- OR Produced Identification
Type of Identification Type of Identification
Produced Produced
(Signature of Notary Pu (Signature of Notary Publi a rq,, �[ pNY ALAN ADAM
ANTH NY ALAN ADAMS rr
p 'ors 4BL'i
State pf Florida-Notary Public ;_ ;State of Florida-Notary Publi
Commission No. Com=Dn #GG 233619 Commission No. C Co ion# GG 233619
&C7233W0i tar: °� M"o�mission.Expires
dry My Commission Expires r 4?o,r�op�,
''rrr01iri��`` June 28. 2022 �233ti ` June 28, 2022
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