HomeMy WebLinkAboutBUILDING PERMIT APPLICATIONAll APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: JUNE 23, 2021 Permit Number: _________
Building Permit Application
Planning and Development Services
Commercial Residential xBuilding and Code Regulation Division ---------
2300 Virginia Avenue, Fort Pierce FL 34982
Phone: (772) 462-1553 Fax : (772) 462-1578
PERMIT APPLICATION FOR:
PROPOSED IMPROVEMENT LOCATION:
Address: 372 NETTLES BLVD., JENSEN BEACH, FL , 34957
Property Tax ID #: 4502-501-0558-000-7
Site Plan Name: CHAFFIN/CINAGLIA
Project Name: CHAFFIN/CINAGLIA -SINGLE FAMILY RESIDENCE
I DETAILED DESCRIPTION OF WORK:
CONSTRUCTION OF A NEW SINGLE FAMILY RESIDENCE
New Electrical Meter --,,£........l _ _ Second Electrical Meter______
I CONSTRUCTION INFORMATION:
Additional work to be performed under this permit check all that apply:
i Mechanical Gas Tank Shutters ¥ Windows/Doors
Lot No. 372
Block No . ___
Pond
Pitch~Iectric t Plumbing
_Gas Piping
_ Sprinklers Generator Y-Roof ---
Total Sq. Ft of Construction: _1_,9_48______ Sq. Ft. of First Floor: 938/1,010 SECOND FLOOR
Cost of Construction : $ 445,000.00 Utilities: X sewer _Septic Building Height: ____
OWNER/LESSEE: CONTRACTOR:
Name SHARON S. CINAGLIAISCOTT D. CHAFFIN Name: MACK MATOS
Address: 1321 NETTLES BLVD . Company: MEL-RY CONSTRUCTION, INC.
City: JENSEN BEACH State : -Address : 10967 S. OCEAN DRIVE
Zip Code: 34957 Fax: City : JENSEN BEACH
Phone No. 609-385-8218 Zip Code: 34957 Fax:
E-Ma i I: Scott.chaffin@comcast.netlSharonc216@gmail.com Phone No 772-229-9439
Fill in fee simple Title Holder on next page ( if different E-Mail MACK@MEL-RY.COM
from the Owner listed above) State or County License CGC059412
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.
State : ~
SUPPLEMENTAL CONSTRUCTION L EN LAW INFORMATION:
DESIGNER/ENGINEER: _l\Jot Applicable MORTGAGE COMPANY: _ Not Applicable
N a me : BRADEN &BRADEN Name: -Address: 417 COCONUT AVENUE. #2 Address:
City : STUART State: FL City: State: _FL__
Zip: 34996 Phone 772-287-8258 Zip: Phone
FEE SIMPLE TITLE HOLDER: _ Not 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 pri or 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 restr ictions 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 perm it 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 attorne before com in work or recordin our Notice of Commence ent.
Signature of Owner/ L ssee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OF_ST_,_LU_C_'E_____________
Sworn to (or affirmed) and subscribed before me of
_ x_ Physical Presence or __Online Notarization
this 23RD day of JUNE • 202. by
MacL AA CLfD S
Name of person making statement.
Personally Known _ x__OR Produced Identification
Type of Identification
Prod uc '1'~f-----:---,r-----f---fl'----
r . . -
",;p~:f. "\'~;;" KATHLEEN GANNON
[:( >} MY COMMISS~8~G 914400
···~~foi;i i.o":~"" IRES: January 18 . 2024
.......... Bonded Thru Notar; Public UnderNriters
STATE OF FLORIDA
COUNTY OF---=-:sT~,L:..:.U..::..:CI.:..E___________
Sworn to (or affirmed) and subscribed before me of
_x_ Physical Presence or __Online Notarization
this 23RD day of JUNE • 202~ by
,Mac ", .A~a±p ~
Name of person making statement.
Personally Known _ x __ OR Produced Identification ___
Type of Identification
Produce7 ______..,,---ft-___
...~;~Y. ~~' "" KATHLEEN GANNON
{:? \-~ MYCOMMISS~~~G914400
··-:::.~~ .....o~<'./ PIRES: January 18. 2024
·'·~f.~.~···· Bonded Thru Notary Public Underwriters
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