HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLE i ru FOR APPLICATION TO BE ACCEPTED ``
Date: Permit Number:
R E C E I'.' D PEA;; % 2017
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
PERMIT APPLICATION FOR: Dock/Seawall
PROPOSED IMPROVEMENT LOCATION:
Address: 17 Nettles Blvd.,Jensen Beach, FL 34957
Legal Description: NETTLES ISLAND INC.,A CONDO-SEC II PARCEL 17 AND PRO-RATA SHARE IN COMMON ELEMENTS
(OR 3743-1628)
Property Tax ID#: 4502-501-0203-000-4 Lot No.
Site Plan Name: Block No.
Project Name: Allen Residence
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK:
Install 22'x10' dock along existing seawall.
CONSTRUCTION INFORMATION:
Additional work to be erformed under t is permit—c ec anapply:
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0HVAC _Gas Tank ❑Gas Piping Shutters I___.l Windows/Doors
Electric ❑ Plumbing OSprinklers F]Generator' FI Roof Roof pitch
Total Sq.Ft of Construction: r' S . Ft.of First Floor:
Cost of Construction:$ (D g 9 LS • co Utilities: Sewer Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name Amelia A Allen Name: Christopher L Loudon
Address: 17 Nettles Blvd Company: Marland Construction
City: Jensen Beach - State:FL Address: PO BOX 1138
Zip Code: 34957 Fax: City: Port Salemo State:FL
Phone No. Zip Code: 34992 Fax:
E-Mail: Phone No. 772-223-0105
Fill in fee simple Title Holder on next page(if different E-Mail: marland@bellsouth.net
from the Owner listed above) State or County License: CBC1253377
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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SUPPLEMENTAL CONSTRUCTIOMLIEN 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:
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.
Inconsideration of the granting of this requested permit,I do hereby agree that 1.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 osted on the jobsite
before the first inspection. If you intend to obtain financing, consult with I or an at o y befor
commencing work or recording our Notice of Commencement.
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Signature of Owner/Lessee/Contractor as Agent for Owner Sig ture of Co License Holder
STATE OF fWRI Ne4-1) J
COUNTY OF OCR_a L f STATE OF FLORIDA
COUNTY OF
The forgoing instrument was acknowledged before me The forgoing instrument was acknowledged before me
this/4day of Y 20/ 7 by his 2 day of 20 1 by
(Namenof - (Name f person )
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- ID#=238 450
_ -- NOTARY PUBLIC
AX_r,;Q9Arw wRAr-v D
(Signatur NVap I' "_ iF y �,)2019 (Signatur f N ary ublic-State of Florida)
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Personally,Known - OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification Produced
Commission No. (Seal) Commission No. F L ` � (Seal)
Revised 07/15/2014 I 3-b�b� ��� MY(%O MISSION#FF948042
EXPIRES:JM 05,2020
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REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE OVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE I i-I't5J
INITIALS