HomeMy WebLinkAboutBuilding Permit Application11/4/ZO20 6:16 PM FROM: Office Depot #151 TO.: +17724621578 P. 3
ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED®] �/
Date: 1 Permit Nu
R EIVED
Building Permit App icatic n NOV 05 2020
Planning and Development Services Permlttln DC artment
Building and Code Regulation Division g p
2300 Virginia Avenue, Fort Pierce FL 34982 St. Lycie County, FL
Phone: (772) 462-1553 Fax: (772) 462-1578 Commercial Resedemial
PERMIT APPLICATION FOR: Dock/Seawall
PROPOSED IMPROVEMENT LOCATION:
Address: 1092 NETTLES BLVD
Legal Description: NETTLES ISLAND INC, A CONDO -SECTION II PARCEL 1092 AND PRO-RATA SHARE IN COMMON
ELEMENTS
Property Tax ID #• 4502-501-1279-000-4
Site Plan Name:
Project Name:
Setbacks Front Back: Right Side:
DETAILED DESCRIPTION OF WORK:
CONSTRUCT AN 1 V X 18.5' MARGINAL DOCK
Left Side:
Lot No. 1092
Block No.
CONSTRUCTION INFORMATION:
ACIditional work to be performed under
11HVAC Gas Tank
tispermit-check
❑Gas Piping
a11
apply:
_ Shutters
❑ Windows/Doors
Electric 0 Plumbing
Sprinklers
Generator
Roof Roof pitch
Total Sq. Ft of Construction:
S . Ft. of First Floor:
1= -L y 4 a
a Utilities:Sewer
OSeptic
Building Height:
OWNER/LESSEE:
CONTRACTOR:
Name TAYLOR BARNEY
Name: OTIS LEONARD
Address: 1092 NETTLES BLVD
Company: OTIS LEONARDS DOCKS & ACCESSORIES
City: JENSEN BEACH State: FL
Address: 1608 APACHE AVE
Zip Code- 34957 Fax:
City: STUART State: FL
Phone No. 606-465-0122
Zip Code: 34994 Fax:
E-Mail: bameytaylor18@gmail.com
Phone No. 772-263-2764
Fill in fee simple Title Holder on next page (if different
E-Mail: LEONARDSTR@,AOL.COM
from the Owner listed above)
,Mate or County License. 3 ' -7- 3
it value of construction is $Z500 or more, a RECORDED Notice of Commencement is required.
11/4/2020 6:16 PM' FROM: Office Depot #151 TO: +17724621578
I SUPPLEMENTAL CONSTRUCTION -LIEN LAW INFORMATION: I
DESIGNER/ENGINEER: _ Not Applicable MORTGAGE COMPANY: _ Not Applicable
Name: Name:
Address: Address:
City: PAUL WELCH, INC State: City: State:
Zip: 1984 BILMMBE DR #114 Zip: Phone:
FEE SIMM TITLE HOLDERF f2-(t3S- 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 jobsite
before the first inspection. If you intend to obtain financing, consult with lender or an atto."ey before
commencinamork,or recording vou'r Notice of Commencement.
A(W
Signa ure o ner/ s Contractor as Agent for Owner
Signature of Contractor/License Holder
STATE OF FLO QA
STATE OF FLORIDA
COUNTY OF Na'd-In
COUNTY OF
The forgoing instrument was acknowledged before me
The forgoing instrument was acknowledged before me
thisc2``day of Qt V- zcsf 20;LZL/ by
this day of . 20_ by
Name person making statement
Name of person making statement
Personally Known OR Produced Identification ✓
Personally Known OR Produced Identification
Type of Identification
Type of Identification
Produced 1ci'�C(cZ �.�r v��- C� �5
Produced
(Signatur of Notary Public- State of Florg'Q)
(Signature of Notary Public- State of Florida )
//'' MYCOh1ARSSION GG
Commission No-L; 6. Di �l� �L *
mission No. (Seal)
� c� EXPIRES: W-ch 6,
��FOP
1
FLOP` Bw*d ThN U90 Notwy
4
REVIEWS
FRONT
ZONING
SUPERVISOR
PLANS
VEGETATION
SEA TURTLE
MANGROVE
COUNTER
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
REVIEW
DATE
RECEIVED
DATE
COMPLETED
tev. 8/2/17
'4 ,