HomeMy WebLinkAboutgamayo slc applic signed notarized0MA11"UNM
All APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: Permit Number:
0
T-TRI- 7 Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax: (772) 462-1578
Residential x
PERMIT APPLICATION FOR: Piling installation along seawall
PROPOSED IMPROVEMENT LOCATION:
Address: 1096 Nettles Blvd., Jensen Beach, FL 34957
Property Tax ID #: 4502-501-1283-000-5
Site Plan Name: Gamayo pilings
Project Name:
Lot No.
Block No.
DETAILED DESCRIPTION OF WORK:
Proposed install of 5 ea. wood pressure treated pilings along existing seawall (to prevent vessel from hitting seawall)
New Electrical Meter Second Electrical Meter
CONSTRUCTION INFORMATION!
Additional work to be performed under this permit— check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters _ Windows/Doors
_ Electric _ Plumbing Sprinklers Generator Roof
Total Sq. Ft of Construction: na Sq. Ft. of First Floor:
Cost of Construction: $ 2250.00 Utilities: Sewer
Septic Building Height:
Pond
pitch
OWNER/LESSEE:
CONTRACTOR:
Name Robert Gamayo
Name: Maurice Petz
Address: 1096 NETTLES BLVD
Company: Linden Marine Construction, Inc.
City: Jensen Beach State: _
Zip Code: 34957 Fax:
Phone No.
Address: 2689 SW Trailside Path
City: Stuart State: FL
Zip Code: 34997 Fax:
Phone No 7723490727
E-Mail:
Fill in fee simple Title Holder on next page ( if different
from the Owner listed above)
E-Mail lindenmarine@yahoo.com
State or County License SLC18466
-�•�� �•-�••,•• V1 11wIn, d ncwnucv rvouce or Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
DESIGNER/ENGINEER: X Not Applicable
Name:
MORTGAGE COMPANY: X Not Applicable
Name:
Address:
City: State:
Zip: Phone
Address:
City: State:
Zip: Phone:
FEE SIMPLE TITLE HOLDER: X Not Applicable
Name:
BONDING COMPANY: X Not Applicable
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 recordirtg your Notice of Commencement.
Siknature of OcGner/ Lessee/Contractor as Agent for Owner I Signature of Con actor i ense Holder
STATE OF FLOR A STATE OF FLORID
COUNTY OF , l.� G; � COUNTY OF S� per,`
Swor o for affirmed) and subscribed before me of
P ysical Presence or Online Notarization
this ay of Me, ./ 2=1 by
anal
Maurice Petz
Name of person making statement.
Personally Known OR Produced Identification f�
Type of Identification
Produced 06 01 dr r Teiberlee_
Notary Public
(Signature, }f ygll is �f��
Commission &mmisslon No. GG 288500(Seal)
Swor (or affirmed) and subscribed before me of
Ph sical Presence or Online Notarization
this Wday of mA../ -2M by
Maurice Petz
me of person making statement.
Personally Known OR Produced Identification _I/'
Type of Identification
Produced QaSigrl h F
I fiotwpub6l /
(SignWrCwfiwllfe9j3t"ida )
Commission rnisslon No. GG 288500 (Seal)
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION SEA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
DATE
COMPLETED
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